Just-in-Time Adaptive Intervention to Improve HIV Prevention and Substance Use in Youth Experiencing Homelessness...

Area of Science:

• Public Health
• Digital Health Interventions
• Adolescent Health

Background:

• Homeless youth face elevated HIV risks and higher mortality from suicide and overdose.
• Existing interventions often overlook real-time, modifiable risk factors.
• Just-in-Time Adaptive Interventions (JITAIs) show promise for HIV prevention and substance use research.

Purpose of the Study:

• To develop and implement a randomized controlled trial for the "Motivating Youth to Reduce Infections, Disconnections, and Emotional Dysregulation" (MY-RIDE) intervention.
• To assess the efficacy of MY-RIDE, a JITAI, in improving HIV prevention and reducing substance use among homeless youth.
• To evaluate the impact of MY-RIDE on protective factors and risk antecedents.

Main Methods:

• A randomized attention-controlled trial enrolling 320 homeless youth aged 18-25.
• Co-designed intervention using the Information-Motivation-Behavioral Skills Model, including nurse-led sessions and 3 months of personalized JITAI messaging.
• Participants receive a smartphone with the intervention app and access to an on-demand nurse helpline.

Main Results:

• Recruitment initiated in Fall 2024, with 192 participants enrolled to date.
• Baseline surveys, HIV/STI testing completed by participants.
• Follow-up assessments at 3, 6, and 12 months to measure intervention uptake and outcomes.

Conclusions:

• The study will determine if MY-RIDE enhances HIV prevention strategies and reduces substance use compared to a control group.
• Evaluation of MY-RIDE's impact on willingness to use pre-exposure prophylaxis (PrEP) and engagement with mental health/substance use services.
• Assessing MY-RIDE's effect on stress, substance use urges, and overall substance use.