Development of a Geographical Momentary Assessment Informed Trauma Intervention to Improve ART Adherence and Viral Suppression in Violence-Affected Persons Living with HIV

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Abstract: Violence-affected persons living with HIV (PLWH) are less likely to successfully adhere to medication regimens, engage in care, and achieve sustained viral suppression. Technology-delivered interventions are necessary to meet the needs of violence affected PLWH (VAPLWH). Currently, there are no mobile interventions for VAPLWH tailored to their daily experiences. This project uses Geographical Ecological Momentary Assessment (GEMA) to identify the daily activity spaces and psychosocial factors that influence engagement in care for VAPLWH. The impact of frequency and timing of violence experienced will be examined in these relationships. Formative work will be conducted to understand VAPLWH needs and preferences for a mobile intervention. The goal is to develop a trauma-informed mobile intervention by adapting an evidence-based intervention, Living in the Face of Trauma (LIFT) and adding novel GEMA identified targets for intervention. Feasibility and acceptability of the intervention will be tested using mixed methods, and a pilot test of the intervention will be conducted to examine preliminary efficacy on adherence and care engagement. Limitations in prior research are examined by using GEMA to identify contextual and situational factors on care in PLWH, explore potential modifying factors related to violence and socio-demographics, and incorporate these into a mobile intervention to improve mental health and address barriers to care for VAPLWH.