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Learn More. They also utilize a wide array of social media.
Accordingly, we developed and implemented weCarea social media intervention utilizing Facebook, texting, and GPS-based mobile social and sexual networking applications to improve HIV-related care engagement and health outcomes. We compared viral load suppression and clinic appointment attendance among 91 participants during the month period before and after weCare implementation. McNemar's chi-square test analyses were conducted comparing the pre- and postintervention difference using paired data.
Since Februaryintervention staff and 91 intervention participants There were ificant reductions in missed HIV care appointments Our highlight the initial success of weCare in improving care engagement and viral suppression. Social media is an important tool, especially for young MSM and transgender women, to support individual- e.
It may also be a useful tool for improving engagement with biomedical HIV prevention tools e. The disproportionate disease burden born by young MSM and transgender women is further exacerbated by low rates of HIV care linkage and retention. It is estimated that about half of people of ages 13—24 years are aware of their HIV status, and overall only about one-quarter are virally suppressed. Social media offers a novel and powerful approach to HIV prevention and care.
Social media are widely available, used frequently by young people, can be accessed instantly, and are relatively inexpensive.
Social media interventions have several benefits for young MSM and transgender women. First, they can have a broad reach to those who are already active social media users. Second, they can increase knowledge, influence health behaviors, provide emotional and social support, and create a sense of community. Given the profound need for innovative approaches to support HIV care and prevention of secondary transmissionthe purpose of this article was to describe the preliminary impact of weCarean ongoing intervention to support HIV care linkage and retention for racially and ethnically diverse young MSM and transgender women 47 curently being implemented in central NC.
This ongoing study is being conducted in Guilford County, NC, at a regional infectious disease clinic that serves a six-county patient catchment area in NC by a community-based participatory research CBPR partnership. This partnership has an established history in intervention development, implementation, and evaluation to meet the needs of traditionally marginalized populations across the HIV care continuum. A version of the weCare intervention is described more fully elsewhere.
Individuals were eligible to participate in weCare who were between the ages of 16—34 years, identified as gay, bisexual, or transgender, and were living with HIV. Potential participants were referred to the study by clinic and health department staff. We also advertised the study on Facebook through paid targeted advertisements and other social media platforms, in a local LGBTQ newspaper, through Craigslist, and posted flyers placed at bars, clubs, and coffee shops.
We also recruited participants through word-of-mouth; enrolled participants would share information about the study with others in their social networks. If eligible, participants completed informed consent procedures with the cyberhealth educator and were enrolled. Enrolled participants chose their preferred social media platforms. Some participants worried that others may see their texts and thus wanted to avoid language that could raise questions about their health and well-being.
Thus, some participants selected words e.
To date, we invited individuals to participate: 91 enrolled and 22 refused. Because weCare focused on linkage and retention in HIV care, we collected extensive contact information from participants to locate participants. Contact information included friends and family who could be contacted to locate participants, aliases on various social media platforms, etc. If the cyberhealth educator had not heard from a participant despite at least bimonthly attempts to be in touch, the cyberhealth educator would attend the participant's next clinic appointment to reconnect with the participant, remind them of the intervention and how the cyberhealth education can help, and determine whether a different social media platform would be better for communication.
Based on each participant's social media platform preferences, the weCare cyberhealth educator uses a combination of Facebook messaging, texting, and app-based instant messaging to communicate using theory-informed messages specific to each participant's place on the HIV care continuum.
We refined existing messages e. Empowerment theory emphasizes movement beyond learning to critical reflection and action. Table 1 provides examples of cyberhealth educator-initiated messages across the HIV care continuum.
These messages served as a guide for the cyberhealth educator; throughout each social media conversation, the cyberhealth educator may exchange multiple messages with a participant about a variety of topics. These messages are tailored to the specific context of the participant e.
Messages that were initiated by the cyberhealth educator often ended in a question to ensure that the social media platform continued to reach the participant and there was participant engagement in the conversation, for example, that the conversation was two way.
Further, the cyberhealth educator used emojis when appropriate to convey feelings within messages. Participants also initiated conversations with the cyberhealth educator as needed or desired. Intervention data were collected and managed in two ways.
First, social media conversations between the one weCare cyberhealth educator and each participant were captured and managed through REDCap Research Electronic Data Capturea secure web application for building and managing online surveys and databases.
Data collected included date of the conversation, who initiated contact the participant or cyberhealth educatorthe social media platform used, and topic of the conversation.
All messages exchanged between the cyberhealth educator and each participant in the same calendar day were coded as one conversation for the purpose of analysis; however, multiple topics could be discussed and thus coded for each conversation. Second, medical chart data were abstracted at the clinic to obtain longitudinal 12 months preintervention implementation and for 12 months of intervention implementation information related to missed HIV medical appointments and viral suppression for each participant.
These data were captured and managed through REDCap. Percentages are presented for all categorical variables and the means and standard deviations of all continuous variables were calculated. All statistics only include participants with complete data for the main outcome variables being analyzed; we choose this approach because some participants were new to care and some participants moved out of state with a care plan, so we did not want to assume that they had missed appointments.
Pre- and post-intervention comparison analysis for categorical variable was done using McNemar's chi-square statistics. The mean age of the 91 weCare participants was See Table 2. A total of 13, messages across 3, conversations were exchanged between the cyberhealth educator and the participants during the month implementation period; again, each conversation denotes 1 day of messaging between the cyberhealth educator and a participant.
Are you ok? Please call to reschedule!
We have bus tickets here in the clinic, so u know for next time. Any one of your family or friends can help u get to the clinic? I got my last refill and they said I needed to reapply or get it approved?
Among the 91 participants who enrolled in the weCare14 participants were new patients at the clinic and 1 participant transferred from another state so they did not have any HIV-related clinic appointment data before the enrollment. One participant passed away and so did not have appointment or viral load data during the month intervention period and was excluded from the outcome analyses.
Therefore, a total of 75 participants were included for the missed appointments data analysis. The percentage of participants with missed appointments decreased from For the viral suppression analysis, five participants did not have viral load data 12 months before enrollment e.
Similar improvements were reported for viral suppression among the 80 participants with complete data; viral suppression rates increased from This success highlights the utility of providing theoretically informed messages that are targeted to diverse young MSM and transgender women, tailored by each participant's preferred social media platform, and personalized to each participant's needs along the HIV care continuum.
Although the intervention dose, including the and content of messages, varied across participants, the messages addressed each participant's unique needs. The use of social media platforms facilitates efficiencies in communication 57 ; yet, the intervention also relies on the cyberhealth educator getting to know the participant, learning what the participant values and using this knowledge to de meaningful messages.
Social media interventions can have a broad reach to individuals who are already active social media users and provide them with support for HIV-related prevention and care. Through our CBPR approach, we translated theory into culturally congruent social Craigslist men sex Raleigh North Carolina messages to help move participants across the HIV care continuum.
Harnessing established social media platforms is a promising approach to support care and medication adherence of young MSM and transgender women living with HIV. The sample in this analysis was relatively small, thus future analyses need to further examine these important health indicators with a larger sample and a longer follow-up period.
These findings do provide preliminary evidence for adding this type of social media intervention to our HIV care toolbox. The article's contents are solely the responsibility of the authors and do not necessarily represent the official views of the US government or the Cone Foundation. National Center for Biotechnology InformationU. Published online Nov 5. Amanda E. BellBS, 2 Cornelius N. Find articles by Amanda E. ZIP: 27617 27616 27615 27614 27613 27612 27610 27608 27609 27601 27603 27604 27605 27606 27607 27602 27619 27620 27621 27622 27624 27626 27627 27628 27634 27636 27640 27650 27656 27658 27661 27668 27675 27676 27690 27697 27698