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E-VOLUTION: A Text Messaging-Powered Intervention-Connection, Support, and HIV Eradication.

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Summary
This summary is machine-generated.

Text messaging interventions improve HIV care for young adults. This study found that automated texts and case manager communication increased medical visits and viral load suppression in youth living with HIV.

Keywords:
HIV/AIDSadolescent healthsexual healthtechnology

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Area of Science:

  • Public Health
  • Digital Health
  • HIV Medicine

Background:

  • Youth and young adults living with HIV are at high risk for poor health outcomes.
  • Effective engagement strategies are needed to support adherence to treatment and medical care.
  • Text messaging interventions offer a feasible and acceptable approach to enhance care.

Purpose of the Study:

  • To evaluate the acceptability, feasibility, and efficacy of a texting intervention (E-VOLUTION) integrated with medical case management for high-risk youth with HIV.
  • To assess the impact of automated text messages and case manager alerts on appointment keeping and viral load suppression.

Main Methods:

  • A longitudinal, nonexperimental, quantitative study involving 100 youth and young adults (average age 22-23, 95% Black, 82% men who have sex with men) living with HIV.
  • The E-VOLUTION intervention sent automated texts for medication reminders, appointment attendance, and mood/housing/financial checks, triggering case manager alerts for challenges.
  • Data collected over 26 months included text message volume, alerts, appointment adherence, and viral load suppression.

Main Results:

  • Automated texts generated 450 alerts, and over 17,000 texts were exchanged between clients and case managers.
  • Increased alerts correlated with a higher likelihood of kept medical appointments (p < .05).
  • More frequent texting with case managers was associated with greater viral load suppression and kept medical visits at 12-month follow-up (p < .01).
  • Substance use was linked to more triggered alerts (p < .01).

Conclusions:

  • The texting intervention was acceptable and culturally responsive for engaging youth with HIV in care.
  • Integrating automated texting with case management shows promise for improving adherence and health outcomes.
  • Future research should explore structured behavioral health assessments within texting frameworks and compare automated versus two-way texting outcomes.