# Connecting Youth and Young Adults to Optimize ART Adherence: Testing the Efficacy of the Youth-Thrive with Me Intervention

> **NIH NIH U19** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2020 · $58,431

## Abstract

Studies show substantial benefit to reduce morbidity and excess mortality for people living with HIV (PLWH)
who adhere to antiretroviral therapy (ART), and to lower the probability of forward transmission to sexual
partners. Despite efforts to maintain engagement of PLWH along the treatment cascade, it is estimated that
only 6-16% of youth and young adults living with HIV (Y/YALWH) maintain suppressed viral load (VL). ART
adherence interventions that leverage software on PCs or through the internet capitalize on consistency in
delivery of content and long-term cost savings; however, to date the peer-to-peer interactivity that has come to
symbolize Web 2.0 remains underutilized in technology-based adherence approaches. Peer-to-peer support is
a recommended strategy to improve ART adherence, is widely used by PLWH, and has an evidence-base for
in-person approaches - particularly in adult populations. Youth in the US are increasingly accustomed to
technology-mediated peer-to-peer interactions, suggesting that intervention approaches that specifically
leverage high-use channels of interpersonal communication and support are needed. The “Thrive with Me”
(TWM) intervention is a technology-delivered peer-to-peer social support intervention grounded in the
Information, Motivation, and Behavioral Skills (IMB) model. TWM includes peer-to-peer interaction, ART
adherence reminders and self-monitoring, mood and substance use self-monitoring, individually-tailored ART
and HIV informational content, and gamification components to optimize ART adherence. A pilot study in adult
MSM showed that those randomized to the TWM intervention demonstrated improvements across all ART
adherence outcomes compared to control participants, with greatest benefits for recent drug-using MSM. As
part of the UNC/Emory Center for Innovative Technology (iTech), we propose to test the efficacy of an adapted
version of the TWM intervention, called Y-TWM, for Y/YALWH. In this 4-year study, 350 Y/YALWH between
the ages of 15-24 with problematic ART adherence at baseline will be randomized to the Y-TWM or a HIV
information-only control intervention for a 5-month period. A target of 50% of Y/YALWH participants with self-
reported alcohol and/or illicit drug use will be enrolled. VL and validated self-reported ART adherence
measures will be collected at baseline, post-intervention, and 3-, and 6-month post-intervention follow up. We
hypothesize that participants in the Y-TWM intervention will demonstrate significant improvements in self-
reported ART adherence and VL at post-intervention compared to control participants, with greatest
improvements among substance-using YLWH. This proposal is innovative for its use of mobile, gaming, and
peer interaction components, which can be readily adopted in clinical and community settings with Y/YALWH.
The proposal advances HIV continuum of care science for Y/YALWH by providing a rigorous evaluation of a
technology-delivered ART adherence intervention...

## Key facts

- **NIH application ID:** 9955296
- **Project number:** 5U19HD089881-05
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Keith Joseph Horvath
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $58,431
- **Award type:** 5
- **Project period:** — → 2022-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9955296

## Citation

> US National Institutes of Health, RePORTER application 9955296, Connecting Youth and Young Adults to Optimize ART Adherence: Testing the Efficacy of the Youth-Thrive with Me Intervention (5U19HD089881-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9955296. Licensed CC0.

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