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Epic Allies: A Gamified Mobile App to Improve Engagement in HIV Care and Antiretroviral Adherence among Young Men Who have Sex with Men

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Abstract

HIV incidence among young men who have sex with men (YMSM) is disproportionally high. Youth living with HIV demonstrate low rates of sustained virologic suppression (VS). Epic Allies, a theory-based behavioral intervention mobile app, utilizes self-management tools, gamification, and social support to improve engagement in care and antiretroviral adherence among YMSM living with HIV. A two-arm individually randomized-controlled trial enrolled 146 participants aged 16 to 24 years old to test the efficacy of Epic Allies to achieve VS. Both study arms showed improved VS at 26-weeks (62.9% intervention; 73.5% control; ARR = 0.93 (95% CI 0.73, 1.18)) and antiretroviral adherence; intervention effects were amplified in regular app users. Issues with recruitment and app usage metrics limit the ability to definitively say that the app was effective in causing behavior changes resulting in improved health outcomes. (ClinicalTrials.gov Identifier: NCT02782130).

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Funding

This study was funded by National Institutes of Health (Grant No. P30 AI064518/AI/NIAID NIH HHS/United States).

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Authors and Affiliations

  1. Institute for Global Health and Infectious Diseases, University of North Carolina, 130 Mason Farm Road, CB# 7030, Chapel Hill, NC, 27599, USA

    Lisa Hightow-Weidman, Kathryn E. Muessig & Alyssa Vecchio

  2. Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina, Chapel Hill, NC, USA

    Lisa Hightow-Weidman & Kathryn E. Muessig

  3. Duke Global Health Institute, Duke University, Durham, NC, USA

    Joseph R. Egger & Alyssa Platt

Authors
  1. Lisa Hightow-Weidman
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  2. Kathryn E. Muessig
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  3. Joseph R. Egger
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  4. Alyssa Vecchio
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  5. Alyssa Platt
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Correspondence to Lisa Hightow-Weidman.

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Appendix

Appendix

See Tables 5, 6, 7, 8.

Table 5 Features of the interventional Epic Allies app
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Table 6 Balance of baseline covariates by missing status (Any Missing)
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Table 7 Baseline characteristics of participants with regular app usagea at 13- or 26-weeks
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Table 8 Usagea and design-adjustedb regression estimatesc between arm differences in outcomes measures
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Hightow-Weidman, L., Muessig, K.E., Egger, J.R. et al. Epic Allies: A Gamified Mobile App to Improve Engagement in HIV Care and Antiretroviral Adherence among Young Men Who have Sex with Men. AIDS Behav 25, 2599–2617 (2021). https://doi.org/10.1007/s10461-021-03222-y

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