Evaluation of a Computer-Based System using Cell Phones for HIV people in Peru

描述(由申请人提供)：我们建议开发和评估一种使用手机的计算机干预措施，以提高秘鲁成年艾滋病毒阳性患者对抗逆转录病毒治疗(ART)的依从性，并支持降低艾滋病毒传播风险。坚持抗逆转录病毒疗法对于个人一级的治疗成功和避免艾滋病毒耐药株的出现至关重要。在秘鲁，最近引入了抗逆转录病毒疗法，坚持艾滋病毒治疗尚未得到适当解决。需要使用手机等信息技术的创新方法，以提高艾滋病毒/艾滋病患者遵守抗逆转录病毒治疗的程度。这项研究的具体目的是：1)进行形成性研究，以评估要纳入基于计算机的系统中的特定文化行为信息；2)开发和测试基于手机的交互式计算机系统，以提高对抗逆转录病毒治疗的依从性，并传递减少艾滋病毒传播风险的信息；3)评估该系统对抗逆转录病毒坚持和性风险行为的影响。为了实现这些目标，我们将进行为期12个月的干预的随机对照试验，比较在Via Libre接受ART的患者中[1]护理标准(n=50)和[2]护理标准加基于手机的系统(n=50)，Via Libre是一个为帮助艾滋病毒携带者而设立的非政府组织。我们将招募100名18岁以上的成年人，他们目前正在学习艺术，并表示同意。这些患者将在为期一年的研究期间被招募，并将被随机分配到接受基于手机的系统或护理标准。两组之间的结果将通过每月调查(通过电话或互联网)进行监测，以确定干预对抗逆转录病毒治疗依从性和性危险行为的影响。自我报告的服药依从性和对诊所预约的遵守；以及自我报告的艾滋病毒传播危险行为将是主要的兴趣终点；还将评估对艾滋病毒-1病毒载量和CD4计数的影响。干预组将通过他们的手机收到：1)通过他们的手机接受抗逆转录病毒治疗并参加预定的艾滋病毒诊所预约的定制提醒；以及2)通过他们的手机收到定制的减少艾滋病毒传播风险的信息。这项试点随机对照试验将确定对这一基于手机的系统进行更大规模评估的必要性和方向，以评估在资源匮乏的环境中对艾滋病病毒携带者脆弱人群的抗逆转录病毒治疗依从性和性行为的影响。

DESCRIPTION (provided by applicant): We propose to develop and evaluate a computer-based intervention using cell phones to enhance adherence to antiretroviral treatment (ART) and support of HIV transmission risk-reduction among adult HIV- positive patients in Peru. Adherence to ART is critical for treatment success at the individual level and to avoid the onset of resistant strains of HIV. In Peru, where ART has recently been introduced, adherence to HIV treatment has not yet beenjaddressed properly. Innovative approaches using information technologies such as cell phones are needed to increase adherence to ART for people with HIV/AIDS. The specific aims of the study are to: 1) Conduct formative research to assess culturally-specific behavioral messages to be included in the computer-based system; 2) Develop and test an interactive computer-based system using cell phones to enhance adherence to ART and to deliver HIV transmission risk reduction messages; 3) Evaluate the impact of the system on antiretroviral adherence and sexual risk behaviors. To achieve these aims, we will conduct a randomized controlled trial of a 12-month intervention, comparing [1] standard-of- care (n=50) with [2] standard-of-care plus cell phone-based system (n=50) among patients receiving ART at Via Libre, a non-governmental organization established to help people with HIV. We will recruit 100 adults over 18 years old who are currently on ARTs and give consent. The patients will be recruited during a one- year study period and will be randomly assigned to receive either a cell phone-based system or the standard-of-care. Outcomes between the two groups will be monitored using monthly surveys (by phone or the Internet) to determine effects of the intervention on ART adherence and sexual risk behaviors. Self- reported medication adherence and adherence to clinic appointments; and self-reported HIV transmission risk behaviors will be the primary endpoints of interest; impact on HIV-1 viral load and CD4 count also will be assessed. The intervention group will receive: 1) Tailored reminders via their cell phones to take their ART and attend scheduled HIV clinic appointments; and 2) Tailored HIV transmission risk reduction messages via their cell phones. This pilot randomized-controlled trial will define the need and direction for larger evaluations of this cell phone-based system to assess impact on ART adherence and sexual behaviors of vulnerable populations living with HIV in resource-poor settings.