Individualized texting for adherence building (iTAB) for methamphetamine users living with HIV: A pilot randomized clinical trial.
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Abstract
BACKGROUND Methamphetamine METH use poses a barrier to antiretroviral therapy ART adherence We evaluated the efficacy of the individualized texting for adherence building iTAB intervention among persons living with HIV PLWH who meet criteria for METH use disorder We examined daily associations between ART adherence and text reported METH use and depressed mood METHODS We conducted a single site 2 arm 6 week pilot randomized clinical trial comparing a personalized bidirectional text messaging system iTAB n 50 to an active control condition n 25 All participants received adherence psychoeducation and daily texts assessing METH use and depressed mood The iTAB group received personalized daily ART reminder texts ART adherence was monitored using Medication Event Monitoring System MEMS caps RESULTS Response rates to daily ART reminder texts were high 79 with good concordance between MEMS derived and text reported ART adherence p Under 001 Intervention groups did not differ in MEMS derived ART adherence 68 iTAB 70 active control p 68 however participants in the iTAB group had fewer METH use days median 14 4 iTAB 22 0 active control p 05 Text reported METH use but not depressed mood was associated with poorer MEMS derived ART adherence CONCLUSIONS High text response rates and good concordance between MEMS derived and text reported adherence suggests text messaging is a feasible intervention delivery approach that provides a valid indication of ART adherence Reductions in METH use among iTAB participants suggest daily health reminders may help attenuate substance use Further research is needed to substantiate daily text messaging as a harm reduction approach