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Health System-Level Implementation of Digital Health Support for People Living With HIV and Substance Use Disorders:
Ryan P Westergaard1,2, Hailey K Ballard1, Rachel E Gicquelais1,2
1Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States.
JMIR Research Protocols
|August 29, 2025
Summary
A mobile health system, ART-C, aims to improve viral suppression for people with HIV and substance use disorders. This study evaluates its effectiveness in enhancing care engagement and health outcomes.
Area of Science:
- Digital Health
- HIV Medicine
- Public Health
Background:
- People with HIV (PLWH) facing substance use disorders (SUD) and social vulnerabilities struggle with viral suppression.
- Mobile health systems offer potential for enhanced social and behavioral support to improve HIV outcomes.
Purpose of the Study:
- Implement and evaluate the Antiretroviral Therapy Care Coordination (ART-C) digital health system.
- Improve HIV viral suppression and reduce missed clinic visits in a multisite HIV care program.
Main Methods:
- ART-C implemented across 8 Vivent Health clinics in multiple states.
- Utilized a customized smartphone app (Connections) for peer support and enhanced features for SUD patients.
- Stepped-wedge clinical trial design to evaluate effectiveness and mixed methods for implementation.
Main Results:
- Preimplementation data shows significant rates of missed visits (45-70%) and viral nonsuppression (14-37%).
- Of 6710 patients, 25.68% had SUD, 42.1% missed visits, and 20.18% had viral nonsuppression.
- 86 participants recruited; data collection ongoing until 2027.
Conclusions:
- The study will assess the effectiveness of a mobile health intervention for PLWH with SUD.
- Implementation strategies for ART-C will be evaluated to support care engagement and viral suppression.
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