The effect of a combined mHealth and community health worker intervention on HIV self-management

Objective: To identify demographic, social, and clinical factors associated with HIV self-management and evaluate whether the CHAMPS intervention is associated with changes in an individual's HIV self-management.

Method: This study was a secondary data analysis from a randomized controlled trial evaluating the effects of the CHAMPS, a mHealth intervention with community health worker sessions, on HIV self-management in New York City (NYC) and Birmingham. Group comparisons and linear regression analyses identified demographic, social, and clinical factors associated with HIV self-management. We calculated interactions between groups (CHAMPS intervention and standard of care) over time (6 and 12 months) following the baseline observation, indicating a difference in the outcome scores from baseline to each time across groups.

Results: Our findings indicate that missing medical appointments, uncertainty about accessing care, and lack of adherence to antiretroviral therapy are associated with lower HIV self-management. For the NYC site, the CHAMPS showed a statistically significant positive effect on daily HIV self-management (estimate = 0.149, SE = 0.069, 95% CI [0.018 to 0.289]). However, no significant effects were observed for social support or the chronic nature of HIV self-management. At the Birmingham site, the CHAMPS did not yield statistically significant effects on HIV self-management outcomes.

Discussion: Our study suggests that CHAMPS intervention enhances daily self-management activities for people with HIV at the NYC site, indicating a promising improvement in routine HIV care.

Conclusion: Further research is necessary to explore how various factors influence HIV self-management over time across different regions.