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Updated: Mar 3, 2026

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings

Published on: March 30, 2014

Using the multiphase optimization strategy (MOST) to optimize an HIV care continuum intervention for vulnerable

Marya Viorst Gwadz¹, Linda M Collins², Charles M Cleland³

¹Center for Drug Use and HIV Research, Rory Meyers College of Nursing, New York University, New York, NY, USA. mg2890@nyu.edu.

BMC Public Health

|May 6, 2017

Summary

This study uses the Multiphase Optimization Strategy (MOST) to develop an effective and affordable intervention for improving HIV care engagement and antiretroviral therapy (ART) adherence among Black and Hispanic individuals living with HIV.

Keywords:

African American Antiretroviral initiation Black Disparities HIV care HIV care continuum Hispanic Intervention MOST Multiphase optimization strategy

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Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model

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Area of Science:

Public Health
Health Services Research
Behavioral Science

Background:

Over half of people living with HIV (PLWH) in the US are not engaged in care or taking antiretroviral therapy (ART), disproportionately affecting African Americans/Blacks and Hispanics.
Barriers to care and ART initiation are multi-level, including individual (e.g., substance use), social (e.g., stigma), and structural factors (e.g., access to services).

Purpose of the Study:

To develop a highly efficacious, efficient, scalable, and cost-effective intervention to improve engagement in the HIV care continuum for African American/Black and Hispanic PLWH.
To utilize the Multiphase Optimization Strategy (MOST) to identify effective intervention components and optimize for cost-effectiveness.

Main Methods:

Employing MOST with a fractional factorial design to evaluate five culturally-based intervention components (counseling, pre-adherence preparation, support groups, peer mentorship, patient navigation).
Recruiting a diverse sample of 512 African American/Black and Hispanic PLWH using targeted community sampling and peer recruitment.
Identifying mediators and moderators of intervention efficacy and using mathematical modeling for cost-effectiveness optimization.

Main Results:

The study aims to identify which intervention components significantly improve HIV viral suppression, ART adherence, and care engagement.
Mediators, moderators, and cost-effectiveness of the optimized intervention package will be determined.

Conclusions:

This study is the first to apply the MOST framework to HIV prevention and treatment.
The research will yield a culturally tailored, cost-effective intervention optimized for efficacy, efficiency, and scalability to improve the HIV care continuum for vulnerable populations.