Would people living with HIV be willing to self-report on daily substance use and antiretroviral therapy (ART) adherence using a smartphone app?
[Photo: Dr. Sarahmona Przybyla]
That was a question researchers from the University at Buffalo set out to answer in a recent study. They were pleased to find that participants not only found the app easy and convenient to use — they were also willing to provide honest responses.
“Reporting was actually high – we had 95 percent compliance with daily report completion. A key finding of our study was the ability for people living with HIV to feel comfortable reporting on sensitive health behaviors,” said Dr. Sarahmona Przybyla, the study’s lead author and clinical assistant professor of community health and health behavior in UB’s School of Public Health and Health Professions.
A willingness to report the use of alcohol or drugs was significant because substance use is one of the most reliable predictors of poor adherence to ART, the researchers note.
Their findings, published this month in the journal AIDS Research and Treatment, were more surprising considering that the majority of the 26 study participants had never used a smartphone before. After some initial smartphone training from research staff, they completed their reports with ease.
In the future, the app could aid in users’ decision to use alcohol since some participants in this study reported it helped them understand exactly how much they were drinking.
And it helped users establish a pattern. “I think the surprising thing is how much the app and the text reminders helped the participants to develop a routine,” said Rebecca Eliseo-Arras, a study co-author and senior research analyst at UB’s Research Institute on Addictions. “For instance, some reported that the text message reminded them to do the report, but the report actually made them think about whether or not they took their medication and, if they didn’t, it prompted them to go take their medications.”
Dr. Przybyla said it’s important to note that the average time since diagnosis among study participants was 17 years and many of their friends and relatives were likely aware they had HIV. As a result, participants probably felt more comfortable completing the reports around others than someone who was more recently diagnosed and may not have been open about disclosing their disease status to others.
The app could help lead to quicker intervention in cases where a patient has missed a number of doses.
“Life expectancy has changed dramatically as a result of advances in pharmacotherapy, which is wonderful, but adherence is key. You can live a long, healthy life with HIV, but you have to take your meds,” said Dr. Przybyla, who is interested in studying the role mobile technology can play in understanding health behaviors.
“Now that we have this data, we can reach out to people with HIV and say, ‘We’ve noticed you’ve been using substances and that seems to be related to the fact that you’ve missed your doses — what can we do to help you?’ It’s putting prevention in their pockets.”