Introduction
Background
Study objectives
Methods
Study setting
Study population
Intervention development
Ecological momentary assessment
Recruitment and enrollment
Qualitative evaluation
Results
Characteristic |
N (%) |
---|---|
Sociodemographic variables | |
Median age, years (IQR) | 49.3 (45.0–54.6) |
African American (%) | 17 (89%) |
Male (%) | 12 (63%) |
High school/GED (%) | 14 (74%) |
Ever married (%) | 5 (26%) |
Income, yearly < $5000 (%) | 8 (42%) |
In prison, ever (%) | 9 (47%) |
Homeless, ever (%) | 5 (26%) |
Substance use variables* | |
Cigarette use (%) | 14 (74%) |
Alcohol use (%) | 8 (42%) |
Marijuana use (%) | 10 (53%) |
Cocaine use (%) | 3 (15%) |
Heroin use (%) | 4 (26%) |
Injecting drug use, any (%) | 3 (16%) |
Clinical variables†
| |
Prescribed ART at enrollment (%) | 16 (84%) |
Hepatitis C virus seropositive (%) | 7 (37%) |
Median CD4 (IQR) | 171 (95–262) |
CD4 < 200 cells/mcL (%) | 10 (53%) |
Median HIV viral Load (copies/mL) (IQR) | 18,938 (3458–103,437) |
Study retention and losses to follow-up
Acceptability of intervention components
“It was helping me stay a grip with things that was going on in my life, which was drugs, and it was a reminder because it would ask me, ‘Did you use?’ And I was able to say, ‘No, no,’ you know, so it did help me, especially with my appointments and what my goals was it did help…. I’m gonna miss that now. I just hope and pray that everything goes still smooth. I haven’t missed an appointment since then.” (Participant, 58 year-old woman)
“They told me about the app and it was a free download and I downloaded it on my regular phone. ‘Cause I liked it so much. It just it doesn’t feed into your database…. ‘cause it’s a whole different app itself. But I did set up a reminder for it.” (Participant, 48 year-old man)
“By me helping myself I will help others, because I had some associates that was dealing with stuff by not being compliant, and I had this phone. It was like, ‘How can I get in this program? Because I need something.’ Because they go through a lot throughout the day and you forget, like I forgot things today. So having that phone, that reminder is so good. It was so good.” (Participant, 37 year-old man)
“She’s very smart, she works with you not against you, you know, and that’s what I like about her…they’re the kind of people I like to have in my life.” (Participant, 55 year old man)“[My Peer Navigator] is one of those people that you just know she’s in your corner. [She] listened. She didn’t judge. She didn’t nag. She just listened to what you have to say.” (Participant, 48 year old man)“I had to go in the hospital and she was right there. She walked it through everything that I needed. Thank God she was there because she helped the hospital process move along. So they wouldn’t forget me in the emergency room where—I remember one time I was in there and they kept me on a bedpan for almost an hour and a half. And when [peer navigator] called and she said, “How’s it going,” and I told her, and before I knew it somebody was in that room. She’s really helpful, and I appreciate it and I love her. That’s my girl.” (Participant, 58 year-old woman)
“For some of them, some of their barriers were depression. So they just weren’t self-motivated to do things. And just having me call them once a week to check in, just to have a conversation, and to show them other outlets of where they can go and talk to people was helpful too.” (Peer-navigator, 36 year-old woman)
“The navigation worked well. For most of them, the phone worked well. A lot of them more than anything appreciated the reminders. The appointment reminders and the take their medication [reminders] ‘cause some of ‘em just forget to take their meds.” (Peer Navigator, 68 year-old woman)
“The ones that suffered with mental health issues, depression mostly, they really liked the mood questions. It helped them gauge how they were feeling and it was a way of getting it out, you know what I mean, it was a way of expressing themselves, it made them feel a little bit better, even if it was temporary relief. (Peer Navigator, 36 year-old woman)
“I know they liked the phone they did find it useful… they also appreciated more the human contact. Knowing somebody cared. Knowing that if I got an issue I can call this person up.