Abstract
BACKGROUND: We created My Personal Health Guide, a relational agent-based mobile health app to improve antiretroviral therapy (ART) adherence among young African American men who have sex with men (AAMSM), a priority population for developing treatment-as-prevention interventions. We assessed the efficacy of My Personal Health Guide on improving ART adherence among young AAMSM with HIV over 6 months. METHODS: We implemented a randomized controlled trial among young AAMSM (18-34 years) with nonoptimal ART adherence throughout the United States. Participants were randomized to My Personal Health Guide or a control arm. ART adherence was assessed with Wilson's 3-item self-reported adherence measurement and dichotomized at ≥80%. Generalized estimating equations were employed to evaluate the effect of My Personal Health Guide over time, with P < .05 considered statistically significant. RESULTS: A significant group effect (P = .014) indicated that those randomized to My Personal Health Guide were 1.54 times (95% CI, 1.25-12.50) more likely to achieve ≥80% adherence throughout the study duration, after adjusting for HIV treatment adherence self-efficacy, Hispanic ethnicity, unemployment, residing in the South, and serious substance use. CONCLUSIONS: This randomized controlled trial demonstrated statistically significant efficacy of the My Personal Health Guide app in improving ART adherence among young AAMSM. As hypothesized, a >10% effect for improved ART adherence was observed at 6-month follow-up among those randomized to the My Personal Health Guide app. These findings provide evidence of efficacy out to 6 months of My Personal Health Guide use to improve ART adherence among young AAMSM.