Randomized Control Trial of Positive Peers mHealth app as a clinic-based intervention to optimize HIV outcomes among young, minority persons living with HIV

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Project Summary/Abstract The Positive Peers mobile app is an original platform developed by and for the hardest to reach HIV disparity populations, young people with HIV who identify as racial, ethnic and/or sexual/ gender minorities. This app holds potential to provide extensive, customizable, self- management tools (i.e., wellness tracker, community forum, chat, frequent original blogs) to young people with HIV anywhere in the US. The Positive Peers app provides health information, health management tools and virtual community support. While the app itself offers a safe place for young persons with HIV to get health information and support, it's use is enhanced by the presence of local peer administrators who provide navigation, support and coaching to users. The proposed study seeks to evaluate its effectiveness in improving viral suppression among minority disparity populations 18-30 years of age who are either newly diagnosed, out of care or not virally suppressed using a randomized control trial design supplemented by an observational cohort of persons who decline to use the app. Clinics in six high priority Ending the HIV epidemic jurisdictions will train staff as app administrators and utilize the app as a clinic- based tool. Our primary objective is to improve HIV outcomes by offering peer interaction, targeted retention and adherence messaging, and interactive trackers and reminders in one smartphone app. Our specific aims are: Aim 1: Compare the effectiveness of HIV care supported by the PPA to usual care for retention in HIV care and viral suppression of newly diagnosed or re-engaged high priority younger adults with HIV. Aim 2: To identify factors that predict user engagement with primary PPA components and associated effects on retention in care, viral suppression, and HIV related perceived stigma. Aim 3: To determine intervention adoption, usability, fidelity, and cost across study sites. These aims will be addressed in a parallel cohort design randomized controlled trial of 250 newly diagnosed or out of care YPWH from designated high priority sites. Participants will be allocated 1:1 to receive the PPA app upon study entry or to a delayed intervention arm where they will receive the usual care with attention controls for 6 months. This will allow for effectiveness evaluation during the earliest phase of adjustment to the diagnosis while also allowing for longitudinal outcome effects.