Promoting Viral Suppression through the CHAMPS+ Intervention in the Deep South

Columbia University Health Sciences, New York NY

Investigators

Abstract

PROJECT SUMMARY Despite efforts to achieve UNAIDS 95-95-95 targets, marked deficits remain in HIV testing, antiretroviral therapy adherence, and viral suppression among a growing number of persons with HIV. Gaps in HIV treatment success are particularly pronounced in the United States (US) Deep South. These suboptimal HIV health outcomes occur at a time when clinicians have limited time and the US healthcare system remains fragmented, further exacerbating the challenges inherent in the lives of underserved, marginalized groups, such as persons with HIV . In this way, the development and evaluation of interventions using a resource-savvy cadre of community health workers holds promise for addressing these challenges. Yet, gaps exist in the community health worker literature, and research is needed to bring community health worker interventions to scale to ameliorate the large gaps in the US HIV Care Continuum. In response, our highly experienced study team has developed and tested the Community Health Workers And MHealth to ImProve Viral Suppression (CHAMPS) intervention which leverages mobile health (mHealth) technology to create a multi-component intervention that targets multiple levels (individual, social and sexual networks, and community) to improve antiretroviral therapy adherence and viral suppression . We propose to build on our strong preliminary data of extant intervention work in persons with HIV by leveraging our CHAMPS intervention which will be delivered by personnel from four HIV care settings in the Deep South. The CHAMPS+ intervention is delivered via an mHealth platform to support persons with HIV to self-manage their antiretroviral regimens and adds to the extant CHAMPS intervention by adding a community health worker-delivered supportive counseling (sexual behavior and substance use) during periods of non-suppression to prevent HIV transmission. This proposed study also builds upon our mChoice (U01PS005229) and WiseApp (R01HS025071) studies to improve antiretroviral adherence and viral suppression in the Deep South. The proposed study design has a three-fold purpose of: 1) engaging the target population in the development of culturally relevant recruitment materials and retention strategies for the proposed study, 2) assessing the clinical effectiveness and sustainability of the intervention in Deep South settings, and 3) evaluating regionalized implementation factors guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Ultimately, this study will test CHAMPS+ to promote antiretroviral adherence and suppressed viral load for persons with HIV in Alabama, Louisiana (Orleans Parish), and Mississippi. Importantly, our multi-component intervention targets multiple levels to address non-suppression--an innovative and impactful component likely to be of great public health import.