Qualitative Results from a Pilot Study of an Automated Directly Observed Therapy Intervention Using Artificial Intelligence with Conditional Economic Incentives among Young Adults with HIV.

Digitally monitoring and supporting daily antiretroviral therapy (ART) is a promising strategy for enhanced adherence among young adults with HIV (YWH). We implemented an innovative mobile app-based intervention that included automated directly observed therapy (aDOT) using artificial intelligence,...

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Publicado en:AIDS & Behavior Vol. 29; no. 9; pp. 2946 - 2956
Autores principales: Wagner, L. Danielle, Mancuso, Noah, Stoner, Marie C. D., Smith, Louis, Ming, Kristin, Patani, Henna, Sukhija-Cohen, Adam C., Granados, Yancy, Napierala, Sue, Saberi, Parya
Formato: clinical trial research tables/charts Journal Article
Publicado: Springer Nature Sep2025
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Qualitative Results from a Pilot Study of an Automated Directly Observed Therapy Intervention Using Artificial Intelligence with Conditional Economic Incentives among Young Adults with HIV.
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          Wagner, L. Danielle
          Mancuso, Noah
          Stoner, Marie C. D.
          Smith, Louis
          Ming, Kristin
          Patani, Henna
          Sukhija-Cohen, Adam C.
          Granados, Yancy
          Napierala, Sue
          Saberi, Parya
        affil: https://ror.org/052tfza37 Women's Global Health Imperative, RTI International, Berkeley, CA, USA
      sug:
        subj:
          HIV Infections Drug Therapy
          Anti-Retroviral Agents Therapeutic Use
          Mobile Applications
          Directly Observed Therapy
          Automation
          Artificial Intelligence
          Motivation
          Internet-Based Intervention
          Reminder Systems
          Medication Compliance Evaluation
          Human
          Male
          Female
          Young Adult
          Adult
          United States
          Pilot Studies
          Clinical Trials
          Qualitative Studies
          Semi-Structured Interview
          Purposive Sample
          Thematic Analysis
          HIV-Positive Persons
          Biometrics
          Funding Source
          Adult: 19-44 years
          Male
          Female
      ab:
        Digitally monitoring and supporting daily antiretroviral therapy (ART) is a promising strategy for enhanced adherence among young adults with HIV (YWH). We implemented an innovative mobile app-based intervention that included automated directly observed therapy (aDOT) using artificial intelligence, medication reminders, and conditional economic incentives (CEIs). This intervention used facial recognition to track and record YWH's daily ART adherence. CEIs were given based on daily app use. A pilot study of the aDOT + CEI app intervention was conducted among YWH ages 18–29 for 3 months. We recruited virally unsuppressed YWH from AIDS Healthcare Foundation clinics in California and Florida and conducted qualitative interviews with YWH and providers regarding the intervention's motivators, deterrents, and helpfulness. Thirteen YWH and 5 providers were interviewed. YWH found the CEIs supported their adherence; however, most YWH did not find the CEI amount sufficiently motivating. The primary motivator for consistent app use was to improve health, and the app reminders were most helpful in improving adherence. YWH desired more reassurance and explanation about app privacy features. Providers suggested incorporating the intervention into counseling for newly diagnosed patients and recommended the intervention to help facilitate viral suppression with oral ART for those interested in transitioning to long-acting injectable ART. YWH and providers found the intervention helpful in reminders to take ART and in tracking adherence. Refinements to the CEI amount may further enhance the intervention. Additional research is needed to test the efficacy of a refined aDOT + CEI intervention to improve viral suppression in a larger sample.
        Resumen: El seguimiento digital y el apoyo a la terapia antirretroviral (TAR) diaria es una estrategia prometedora para mejorar la adherencia entre los adultos jóvenes con VIH (YWH). Implementamos una innovadora intervención basada en una aplicación móvil que incluyó terapia automatizada de observación directa (aDOT) utilizando inteligencia artificial, recordatorios de medicamentos e incentivos económicos condicionales (CEI). Esta intervención utilizó el reconocimiento facial para rastrear y registrar la adherencia diaria al tratamiento antirretroviral de YWH. Los CEI se dieron en función del uso diario de la aplicación. Se llevó a cabo un estudio piloto de la intervención de la aplicación aDOT + CEI entre jóvenes de 18 a 29 años durante 3 meses. Reclutamos a YWH no suprimidos viralmente de las clínicas de AIDS Healthcare Foundation en California y Florida y realizamos entrevistas cualitativas con YWH y proveedores sobre los motivadores, los elementos disuasorios y la utilidad de la intervención. Se entrevistó a trece YWH y 5 proveedores. YWH encontró que los CEI apoyaban su adhesión; sin embargo, la mayoría de los YWH no encontraron la cantidad de CEI lo suficientemente motivadora. El principal motivador para el uso constante de la aplicación fue mejorar la salud, y los recordatorios de la aplicación fueron más útiles para mejorar la adherencia. YWH quería más tranquilidad y explicaciones sobre las funciones de privacidad de las aplicaciones. Los proveedores sugirieron incorporar la intervención en el asesoramiento para los pacientes recién diagnosticados y recomendaron la intervención para ayudar a facilitar la supresión viral con TAR oral para aquellos interesados en la transición a TAR inyectable de acción prolongada. YWH y los proveedores encontraron que la intervención fue útil para recordar que se debe tomar el tratamiento antirretroviral y para hacer un seguimiento de la adherencia. Los refinamientos en el monto de la CEI pueden mejorar aún más la intervención. Se necesita investigación adicional para probar la eficacia de una intervención refinada de aDOT + CEI para mejorar la supresión viral en una muestra más grande.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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