Acceptability and perceived usefulness of the CHAMPS intervention for improving medication adherence among people with HIV in Alabama and New York

Abstract

Background

Antiretroviral therapy allows people with HIV to manage the disease as a chronic illness rather than a fatal diagnosis as regular adherence can lead to viral suppression. It is estimated, however, that less than two-thirds of people with HIV in the United States sustain viral suppression. Community Health Workers and mHealth to Improve Viral Suppression (CHAMPS) is useful for improving and personalizing care and may help promote medication adherence among people with HIV.

Objective

We aimed to understand acceptability and perceived usefulness of the CHAMPS intervention.

Methods

In-depth interviews were carried out with a total of 42 intervention participants from the RCT of the CHAMPS intervention versus standard of care on ART adherence and viral suppression among PWH, which enrolled participants between May 2021 and May 2023 in the NYC and Birmingham, AL areas, to obtain feedback on the CHAMPS intervention, a combination of CHW sessions, and the CleverCap app and device. Interviews were transcribed and coded using a codebook guided by the Unified Theory of Acceptance and Use of Technology framework.

Results

Participants ranged from 19 to 65 years old with a mean of 47 years. Most participants (62 %) identified as cisgender female, 33 % as cisgender male, 2 % as transgender male, and 2 % as transgender female. Participants believed the CleverCap app and device and CHW sessions were useful for medication adherence and, consequently, reducing viral load. Participants identified varying levels of difficulty with using the intervention, and varying levels of comfort with using the intervention in public settings. Overall, participants felt they could integrate the intervention into their daily lives and that it was instrumental in achieving improved health status and quality of life.

Conclusion

Despite some complexities associated with use of the intervention, participants overwhelmingly demonstrated interest in and were pleased with the CleverCap app and device and CHW sessions for improvement of viral load and overall health status. Positive feedback during the interviews supports future testing of the CHAMPS mHealth and CHW intervention.