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Lessons Learned From the Implementation of Seek, Test, Treat, Retain Interventions Using Mobile Phones and Text Messaging to Improve Engagement in HIV Care for Vulnerable Populations in the United States

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Abstract

In the United States, little is known about interventions that rely on mobile phones and/or text messaging to improve engagement in HIV care for vulnerable populations. Domestic studies using these technologies as part of the National Institute on Drug Abuse “Seek, Test, Treat, Retain” research initiative were queried regarding intervention components, implementation issues, participant characteristics, and descriptive statistics of mobile phone service delivery. Across five studies with 1,135 predominantly male, minority participants, implementation challenges occurred in three categories: (1) service interruptions; (2) billing/overage issues, and; (3) the participant user experience. Response rules for automated text messages frequently frustrated participants. The inability to reload minutes/texting capacity remotely was a significant barrier to intervention delivery. No study encountered confidentiality breaches. Service interruption was common, even if studies provided mobile phones and plans. Future studies should attend to the type of mobile phone and service, the participant user experience, and human subjects concerns.

Resumen

Existe poca información acerca de las intervenciones que utilizan teléfonos móviles y/o mensajes de texto para mejorar el cuidado de VIH en poblaciones vulnerables. Estudios nacionales que utilizan estas tecnologías como parte de la iniciativa sobre la “búsqueda, prueba, tratamiento, retención” del Instituto Nacional sobre el Abuso de Drogas describieron los componentes de la intervención, los aspectos de la implementación, las características de los participantes, y las estadísticas descriptivas relacionadas con el uso de teléfonos móviles. Cinco estudios, con un total de 1.135 participantes predominantemente masculinos y minoritarios, expresaron desafíos de implementación en tres categorías: (1) interrupciones de servicio; (2) problemas de facturación/rebasamiento; y; (3) las experiencias de uso del participante. Las reglas automatizadas en las respuestas de mensajes frustraron a los participantes frecuentemente. La inhabilidad de recargar remotamente los minutos/mensajes de texto fueron una barrera significativa para suministrar la intervención de forma consistente. Es importante destacar que ningún estudio encontró violaciones de confidencialidad. La interrupción del servicio fue común, incluso para los estudios que proporcionaban teléfonos móviles y planes a sus participantes. Futuros estudios deben atender al tipo de teléfono móvil y servicio, las experiencias de uso del participante, y consideraciones sobre la protección de los participantes en la investigación.

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Acknowledgements

The authors would like to acknowledge Terence Johnson for assistance in assembling the cost data.

Funding

Funded by National Institutes of Health R01 DA032057, R01 DA030781, R01 DA030747, R01 DA030793, R34 DA035728.

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Authors and Affiliations

  1. Division of HIV, ID and Global Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, 995 Potrero Avenue, 4th Floor, San Francisco, CA, 94110, USA

    Katerina A. Christopoulos & Lara S. Coffin

  2. Departments of Medicine and Health Policy and Management, UCLA Schools of Medicine and Public Health, Los Angeles, CA, USA

    William E. Cunningham

  3. Division of Infectious Diseases, Warren Alpert School of Medicine at Brown University, Providence, RI, USA

    Curt G. Beckwith

  4. Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, D.C., USA

    Irene Kuo

  5. Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA

    Carol E. Golin

  6. Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA

    Kevin Knight & Patrick M. Flynn

  7. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Anne C. Spaulding

  8. Collaborative Health Studies Coordinating Center, University of Washington, Seattle, WA, USA

    Bridget Kruszka

  9. School of Nursing, Yale University, New Haven, CT, USA

    Ann Kurth

  10. Division of Infectious Disease, University of Illinois at Chicago, Chicago, IL, USA

    Jeremy D. Young

  11. Departments of Medicine and Epidemiology, Columbia University, New York, NY, USA

    Sharon Mannheimer

  12. Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA

    Heidi M. Crane

  13. Services Research Branch, National Institute on Drug Abuse, Bethesda, MD, USA

    Shoshana Y. Kahana

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  1. Katerina A. Christopoulos
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  2. William E. Cunningham
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  3. Curt G. Beckwith
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  4. Irene Kuo
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Correspondence to Katerina A. Christopoulos.

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Conflict of interest

Dr. Christopoulos has been a scientific advisory board member for Roche and a community advisory board member for Gilead. No other conflicts of interest reported.The opinions in this article are those of the authors and do not necessarily reflect official positions of the National Institute on Drug Abuse, the National Institutes of Health, or the Department of Health and Human Services.

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Christopoulos, K.A., Cunningham, W.E., Beckwith, C.G. et al. Lessons Learned From the Implementation of Seek, Test, Treat, Retain Interventions Using Mobile Phones and Text Messaging to Improve Engagement in HIV Care for Vulnerable Populations in the United States. AIDS Behav 21, 3182–3193 (2017). https://doi.org/10.1007/s10461-017-1804-8

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