# Technology Based Community Health Nursing to Improve cART Adherence and Virologic Suppression in Youth Living with HIV (TechN 2 CheckIN): A Regional Multi-site Study

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2020 · $767,176

## Abstract

Human immunodeficiency virus (HIV) infection has disproportionately persisted as a public health threat to
adolescents and young adults (AYA) from minority communities in the United States. HIV has evolved into a
chronic disease, which can be managed in the outpatient setting with antiretroviral therapy (ART) designed to
achieve virologic suppression and life expectancy equivalent for uninfected individuals. However, for AYA,
huge disparities exist compared to adults, with greater proportions unaware of their status, lower rates of care
engagement, retention, and initiation and maintenance of ART, resulting in higher rates of virologic non-
suppression, and development of sequelae including immunologic deterioration and transmission.
Interventions designed to improve outcomes for youth living with HIV (YLHIV) are being sponsored by
agencies including the Centers for Disease Control and Prevention and the National Institutes of Health,
however, most target the early components of the continuum of care (identification, linkage, and ART
initiation). Our research from the HIV Research Network shows that 30-40% of YLHIV are not virologically
suppressed despite being in care, highlighting the need for novel interventions targeting the distal components
of the care continuum. Community health nurse (CHN) interventions have been shown to increase access to
appropriate resources, enhance health care utilization, and promote risk-reducing behavior among AYA. Use
of short messaging service (SMS) messaging can further enhance clinical care by improving attendance at
medical visits, medication adherence, and communication with the health care team. We have used these two
modalities in randomized trials of youth with complex sexually transmitted infections (STIs) in low-income
minority communities with high feasibility and acceptability amongst AYA and their families, remarkable
improvements in visit completion, medication adherence, and reduction in recurrent STIs. The overarching
goal of this project is to build on the evidence from this trial and to repurpose the intervention for YLHIV in the
same community who are having challenges with care and medication non-adherence. We aim to compare the
effectiveness of a technology-enhanced community health nursing intervention (TECH-N 2 CHECK-IN) to a
standard of care control group using a randomized trial design. The central hypothesis is that the intervention
will result in higher rates of adherence to ART and virologic suppression. We have demonstrated our
interdisciplinary team's capacity to follow urban AYA in the community, utilizing the combination of CHNs and
outreach workers to optimize care according to national standards. TECH-IN 2 CHECK-IN aims to enroll 120
YLHIV followed at clinics specializing in HIV care in the Baltimore-Washington Metropolitan area who are
challenged with treatment adherence and randomizing them to receive TECH-IN 2 CHECK-IN vs. standard of
care. Results of this trial will inform b...

## Key facts

- **NIH application ID:** 9892885
- **Project number:** 5R01MD011770-04
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** ALLISON L AGWU
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $767,176
- **Award type:** 5
- **Project period:** 2017-08-02 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9892885

## Citation

> US National Institutes of Health, RePORTER application 9892885, Technology Based Community Health Nursing to Improve cART Adherence and Virologic Suppression in Youth Living with HIV (TechN 2 CheckIN): A Regional Multi-site Study (5R01MD011770-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9892885. Licensed CC0.

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