Positive Connections: Digital Support for Adolescents Living with HIV

Positive Connections: Digital Support for Adolescents Living with HIV

• 1.
  Positive Connections: DigitalSupport for Adolescents Living with HIV Kate Plourde Senior Technical Officer, Research Utilization, GHPN, FHI 360
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  Adolescents and HIV ● Young peopleaccount for 42% of all new non- pediatric HIV infections ● Few know their HIV status ● Linkage to care can be problematic ● While mortality for PLHIV overall is decreasing, mortality among ALHIV is increasing ● Notable gap in programming for ALHIV “I might have HIV, but I still want to have a boyfriend.…get married one day. The nurses won’t tell me about contraception because they think I shouldn’t be having sex.”
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  Why Focus on Retention and Adherence? ● Retention incare over time is challenging for all PLHIV, but especially for adolescents ● LTFU is higher for adolescents than any other age group ● ART adherence (>95%) is critical for achieving viral suppression, but adolescent adherence is sub-optimal
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  Our Goal: Develop andtest an intervention designed to reduce LTFU and to improve retention and adherence among ALHIV
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  Virtual Support Groups ● Limited evidenceon approaches to reach ALHIV ● Group counseling and mHealth approaches demonstrate some evidence ● Potential to overcome barriers to attending in-person meetings
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  Intervention Development Process Concepttesting andyouthdesign workshops Contentand platformdevelopment Feasibility assessment Programrefinement
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  Logic Model Barriers • Lack ofknowledge about HIV • Misconceptions about HIV transmission • Poor treatment literacy • Confusion/ fear associated with new diagnosis • Weak support networks • Fear of stigma Strategies • Informational messaging • Virtual support groups • Access to trained provider Outcomes • Improved knowledge about HIV and HIV treatment • Improved attitudes toward HIV care and treatment • Improved self-worth • Increased support network • Increased informational social support • Increased emotional social support • Increased appraisal social support Results • Increased likelihood of retention in care • Improved treatment adherence
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  Concept Testing
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  Intervention Components Informational Messaging Access to a Trained Facilitator VirtualSupport Group
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  Informational Content: Positive Connections ● Provides adultfacilitators with background information about the needs of ALHIV ● Tips for starting and leading an information and support group ● 14 sessions to be used in a group setting ● Guidance on tracking a program’s progress and success
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  Adaptation of Positive Connections Content for Facebook ● At-a-Glance statements ●Key messages ● Role Model Stories ● Discussion questions ● Review questions and wrap-up statements ● Interactive social activities and games (New!)
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  Intervention Topics ● Understanding HIV ●Disclosure and Developing Trust in Relationships ● Treatment and Adherence ● Nutrition and Health ● Sexual and Reproductive Health ● Health and Positive Prevention ● Violence and HIV ● Communication and Problem- Solving Skills ● Exploring Your Feelings ● Knowing Your Rights: Handling Stigma and Discrimination ● Making Decisions and Planning for the Future ● Your Support Network
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  Intervention Content - Examples ……. …….
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  Pilot Findings ● Facilitators andALHIV were strongly supportive and liked the intervention ● Participants: ○ Felt that the intervention was easy to access and useful ○ Reported that they enjoyed taking part in it, ○ Felt comfortable with the facilitator and group members ○ Wanted to continue the intervention, ○ Would recommend the intervention to other ALHIV ● Overall, facilitators completed most scheduled activities on-time and as intended and felt that using Facebook on phones was easy ● There were some challenges with a few specific activities (i.e. uploading adherence plan photos and posting quizzes) “I am a very timid and shy person. But the intervention helped me. There are certain things I was able to overcome. I felt so miserable when I found out that I’m positive but after interacting with people, I find out that I don’t have to kill myself or die or feel miserable …So I have decided to open up and feel good about myself.” - 18- year-old female
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  Next Steps ● Content modificationbased on results from feasibility assessment ● Outcome evaluation
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  Final Thoughts ● Strategies toreach ALHIV need to be relevant and address barriers to access ● Technology offers broad reach and ability to facilitate human connection ● Facebook appears to provide a feasible and acceptable platform through which to offer information and support to ALHIV
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  Thank You! “Knowing that I'm chattingwith other youths that are positive, it was fun.” “What I liked most is the fact that it gives me more enlightenment about my condition and it also gives me information on how I can deal with it” “I love the interaction because it enabled me to share my problems and worries with the group members”