Positive STEPS: Enhancing Medication Adherence and Achieving Viral Load Suppression in Youth Living With HIV in the United States—Results From an Efficacious Stepped Care, Randomized Controlled Trial

作者：Matthew J. Mimiaga, Lisa M. Kuhns, Katie B. Biello, Jiahao Tian, Margie R. Skeer, Christina Psaros, Ethan Moitra, Diane Chen, Elizabeth A. Yonko, Kenneth H. Mayer, Steven A. Safren, Robert Garofalo · 发表于：JAIDS Journal of Acquired Immune Deficiency Syndromes · 年份：2025 · DOI：10.1097/qai.0000000000003639 · 被引用次数：5 · 研究领域：HIV/AIDS Research and Interventions、HIV-related health complications and treatments、Mobile Health and mHealth Applications

BACKGROUND: In the United States and worldwide, there is a significant number of young people acquiring and living with HIV. Antiretroviral therapy (ART) has led to significant reductions in HIV-related illnesses and deaths, allowing young people living with HIV to manage their condition as a chronic disease. Ensuring high levels of ART adherence is vital for treatment success. Despite this, to the best of our knowledge, there are no efficacious behavioral interventions for improving ART adherence and viral suppression among youth in the United States. METHODS: We conducted a multicity, randomized, controlled trial-in Boston, MA/Providence, RI and Chicago, IL-to examine the efficacy of an stepped care, behavioral and technology-based intervention, "Positive STrategies to Enhance Problem-Solving Skills (Positive STEPS)," compared with a standard of care (SOC) control, for improving ART adherence and viral suppression among youth living with HIV ages 16-29 years. Positive STEPS included the following: step 1: TXTXT, an evidence-based, daily 2-way personalized text message reminder to take ART medications; step 2: only participants with <90% adherence anytime between weeks 5 and 12 postrandomization to the Positive STEPS arm would then receive five 50-minute sessions of manualized individual adherence counseling. If participants' adherence remained at ≥90% , then they did not progress to step 2. ART adherence was measured via Wisepill, an electronic medication monitoring device,...