Mems And Competitive Game Interventions To Promote Art Adherence In Poorly-Adherent Hiv Patients

While HIV/AIDS remains a major epidemic in the US with about 1.2 million people living with HIV, adherence to antiretroviral therapy (ART) remains suboptimal leading to negative patient consequences (increased hospitalization and mortality) and public health risks (drug resistance and disease transmission). Interventions designed to improve ART adherence are warranted as higher ART adherence can significantly improve clinical outcomes. In the proposed study, we evaluate the effectiveness of a competitive game intervention delivered through a smartphone app in conjunction with a passive medication event monitoring system (MEMS) to
enhance ART adherence. The goal is to study the ART adherence and health outcome improvements in a sample of 60 HIV/AIDS patients with detectable viral load (the study sample). During the first month of the proposed five-month study, the MEMS technology will unobtrusively monitor all the patients in the study sample for establishing a baseline of ART adherence. During the next 2-month intervention phase, patients will be randomly assigned to either the intervention or the control group (n = 30 each). The competitive game app will display daily information to intervention patients comparing an individual intervention patient’s ART
adherence to all other patients in the intervention group. The resulting competition in the intervention patients from a desire to “win” in the competitive game is expected to promote ART adherence and decreased viral loads. Withdrawal of the competitive game intervention during the next 1-month period will provide information about maintenance of the ART regimen and related outcomes (e.g., viral loads and drug concentrations).