The development of social capital in a peer-led mHealth cognitive behavioral antiretroviral therapy adherence intervention for HIV + adolescents and young adults

ABSTRACT

Adherence Connection for Counseling, Education, and Support (ACCESS)-I is a peer-led mHealth antiretroviral therapy adherence intervention for adolescents and young adults living with HIV who are in treatment but have detectable viral loads. Participants received five online sessions with peer health coaches who followed a structured intervention manual. Peers maintained intervention fidelity but also engaged in casual discussion that was not directly related to ART adherence or HIV. We conducted a qualitative analysis of the casual interactions that occurred during the ACCESS I intervention. Sessions were transcribed and coded, and these casual interactions were then coded into 10 subcodes to document their content, and also coded for three types of social capital – emotional, informational, and instrumental. Emotional and Informational social capital codes were the most common, while instrumental codes were rare. Activities was the most common topic overall, while encouragement was more common in emotional social capital narratives and personal experience was more common in informational social capital narratives. These casual interactions may strengthen peer-participant relationships, building social capital that could then be used to encourage positive behavior change. Although social capital was not directly measured, these analyses illustrate the value of attending to seemingly casual interactions in peer-led interventions.

KEYWORDS:

• Peer health educators
• intervention
• HIV
• ART adherence
• social capital

Acknowledgments

We acknowledge the time and contribution of the participants, peer health coaches; the Jacobi Hospital Research Office Staff, namely Michael Rosenberg, MD, PhD; and the NYU Meyers information technology team for their support of this project.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Availability of data and materials

The datasets from the ACCESS I study are available from Dr. Navarra on reasonable request.

Additional information

Funding

This work was supported by the National Institute of Nursing Research [grant number K23-NR015970], [grant number R01NR019535, Navarra PI], by the New York University Office of the Provost [grant number A20-0169-001].