Refining a personalized mHealth intervention to promote medication adherence among HIV+ methamphetamine users

Abstract

Mobile health (mHealth) interventions to promote antiretroviral therapy (ART) adherence have shown promise; however, among persons living with HIV who abuse methamphetamine (MA), effective tailoring of content to match the expressed needs of this patient population may be necessary. This study aimed (1) to understand patient perspectives of barriers and facilitators of ART adherence among people with HIV who use MA, and (2) to obtain feedback on the thematic content of an mHealth intervention in order to tailor the intervention to this subgroup. Two separate focus groups, each with 10 HIV+/MA+ individuals, were conducted. Transcribed audio recordings were qualitatively analyzed to identify emergent themes. Inter-rater reliability of themes was high (mean Kappa = .97). Adherence barriers included MA use, misguided beliefs about ART adherence, memory and planning difficulties, social barriers and perceived stigma, and mental heath issues. Facilitators of effective ART adherence were cognitive compensatory strategies, promotion of well-being, health-care supports, adherence education, and social support. Additionally, the focus groups generated content for reminder text messages to be used in the medication adherence intervention. This qualitative study demonstrates the feasibility of using focus groups to derive patient-centered intervention content to address the health challenge at hand in targeted populations.

Keywords:

• focus groups
• methamphetamine
• antiretroviral treatment
• adherence
• mHealth
• short message service

Acknowledgments

The views expressed in this article are those of the authors and do not reflect the official policy or position of the US Government.

Funding

This research was supported by NIDA awards [grant numbers R34DA31058 and P50DA026306] and NIMH award [grant number P30MH062512]. The Translational Methamphetamine AIDS Research Center (TMARC) is supported by Center award [grant number P50DA026306] from the National Institute on Drug Abuse (NIDA) and is affiliated with the University of California, San Diego (UCSD) and the Sanford-Burnham Medical Research Institute (SBMRI).

Notes

1. The TMARC is comprised of Director – Igor Grant, M.D.; Co-Directors – Ronald J. Ellis, M.D., Ph.D., Scott L. Letendre, M.D., and Cristian L. Achim, M.D., Ph.D.; Center Manager – Steven Paul Woods, Psy.D.; Assistant Center Manager – Aaron M. Carr, B.A.; Clinical Assessment and Laboratory (CAL) Core – Scott L. Letendre, M.D. (Core Director), Ronald J. Ellis, M.D., Ph.D., Rachel Schrier, Ph.D.; Neuropsychiatric (NP) Core – Robert K. Heaton, Ph.D. (Core Director), J. Hampton Atkinson, M.D., Mariana Cherner, Ph.D., Thomas D. Marcotte, Ph.D., Erin E. Morgan, Ph.D.; Neuroimaging (NI) Core – Gregory Brown, Ph.D. (Core Director), Terry Jernigan, Ph.D., Anders Dale, Ph.D., Thomas Liu, Ph.D., Miriam Scadeng, Ph.D., Christine Fennema-Notestine, Ph.D., Sarah L. Archibald, M.A.; Neurosciences and Animal Models (NAM) Core – Cristian L. Achim, M.D., Ph.D. (Core Director), Eliezer Masliah, M.D., Stuart Lipton, M.D., Ph.D., Virawudh Soontornniyomkij, M.D.; Administrative Coordinating Core (ACC) – Data Management and Information Systems (DMIS) Unit – Anthony C. Gamst, Ph.D. (Unit Chief), Clint Cushman, B.A. (Unit Manager); ACC – Statistics Unit – Ian Abramson, Ph.D. (Unit Chief), Florin Vaida, Ph.D., Reena Deutsch, Ph.D., Anya Umlauf, M.S.; ACC – Participant Unit: J. Hampton Atkinson, M.D. (Unit Chief), Jennifer Marquie-Beck, M.P.H. (Unit Manager); Project 1 – Arpi Minassian, Ph.D. (Project Director), William Perry, Ph.D., Mark Geyer, Ph.D., Brook Henry, Ph.D.; Project 2 – Amanda B. Grethe, Ph.D. (Project Director), Martin Paulus, M.D., Ronald J. Ellis, M.D., Ph.D.; Project 3 – Sheldon Morris, M.D., M.P.H. (Project Director), David M. Smith, M.D., M.A.S., Igor Grant, M.D.; Project 4 – Svetlana Semenova, Ph.D. (Project Director), Athina Markou, Ph.D., James Kesby, Ph.D.; Project 5 – Marcus Kaul, Ph.D. (Project Director).

Additional information

Funding

Funding: This research was supported by NIDA awards [grant numbers R34DA31058 and P50DA026306] and NIMH award [grant number P30MH062512]. The Translational Methamphetamine AIDS Research Center (TMARC) is supported by Center award [grant number P50DA026306] from the National Institute on Drug Abuse (NIDA) and is affiliated with the University of California, San Diego (UCSD) and the Sanford-Burnham Medical Research Institute (SBMRI).