# Unified Intervention to Impact HIV Care Continuum

> **NIH NIH R01** · UNIVERSITY OF CONNECTICUT STORRS · 2020 · $683,659

## Abstract

This pragmatic adaptive clinical trial will test the effects of a Stigma-Motivational-Decision intervention
designed to increase HIV treatment engagement, retention, and medication adherence for substance using
adolescents and young adults (AYA) living with HIV who are not in clinical care. The intervention uses a
uniquely unified counseling approach at multiple points along the HIV continuum of care. In a first step, we will
use multiple modes of outreach including social media, passive media, clinic records, and chain referrals to
seek and identify HIV positive AYA (age 16 to 25) who are out of HIV care. In Step 2, HIV positive AYA who
are out of HIV care and substance using will be enrolled in a phone-delivered counseling intervention to
address substance use, HIV stigmas, medical care-related concerns, structural barriers, and other challenges
to engaging youth in HIV care. Counseling will be provided weekly until the time participants are engaged in
care, with a maximum of 12 sessions (up 3-months). We will therefore determine the number of theory-based
phone intervention sessions needed (minimally effective dose) for care engagement and the associated costs.
Once engaged in care, Step 3 will conduct a randomized trial to test the comparative effects and cost
effectiveness of interactive text messaging with opportunities for ongoing supportive problem solving versus
text message reminders to sustain long-term retention in care and medication adherence. HIV positive AYA
are likely to drop out of care because of known challenges such as substance use, social barriers such as
stigma, and concerns regarding treatment. Our 3-step study will use a single theory-based approach to
determine the number of phone-delivered Stigma-Motivational-Decision counseling intervention sessions
necessary to achieve engagement or re-engagement in HIV care, and will test the effects of a low-cost
approach to sustaining long-term retention in care and medication adherence. Participants will be out of
care at baseline and counseled with up to 12 weekly phone-delivered intervention sessions until they
confirm engagement in HIV care. The study will determine the minimally effective counseling dose needed
to engage substance using HIV positive AYA in care. Once participants attend HIV medical appointments,
they will be randomized to either: (a) 15-months of ongoing weekly mobile phone text message check-ins
with the opportunity for brief problem-focused phone support or (b) weekly text message reminders. The
study will test the effects of the counseling and text messaging interventions on maintaining HIV care
retention, medication adherence, and HIV viral suppression over 18-months. The primary endpoint in this
trial is HIV RNA suppression. We will perform economic evaluations to determine the cost-effectiveness of
the engagement-retention-adherence intervention. The proposed pragmatic adaptive trial will therefore
determine the minimally effective dose of counseling an...

## Key facts

- **NIH application ID:** 9954034
- **Project number:** 5R01DA043068-05
- **Recipient organization:** UNIVERSITY OF CONNECTICUT STORRS
- **Principal Investigator:** Lisa A Eaton
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $683,659
- **Award type:** 5
- **Project period:** 2016-08-15 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9954034

## Citation

> US National Institutes of Health, RePORTER application 9954034, Unified Intervention to Impact HIV Care Continuum (5R01DA043068-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9954034. Licensed CC0.

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