Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Mar 28, 2025
Open Peer Review Period: Apr 9, 2025 - Jun 4, 2025
Date Accepted: Dec 1, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Evidence of Efficacy of the My Personal Health Guide Mobile Phone Application on Antiretroviral Therapy Adherence: Results at 1-month of a Randomized Controlled Trial Among Young African American Men who have Sex with Men Living with HIV
ABSTRACT
Background:
Young African American men who have sex with men (AAMSM) experience disproportionately high HIV incidence and are less likely to achieve viral suppression compared to White MSM, an outcome that relies on antiretroviral therapy (ART) adherence. We created My Personal Health Guide, a talking relational agent-based mobile health (mHealth) app to improve ART adherence among young AAMSM.
Objective:
The objective was to determine the efficacy of My Personal Health Guide on improving ART adherence among young AAMSM living with HIV.
Methods:
We implemented a randomized controlled trial (RCT) among young (18-34 years) AAMSM with non-optimal ART adherence throughout the United States. Participants were randomized in a 1:1 ratio using permuted blocks of 8 to the intervention, My Personal Health Guide, or attention control arm. ART adherence was assessed with Wilson’s 3-item self-reported adherence measurement and dichotomized at >80%. Logistic regression models using backward selection were employed to evaluate the efficacy of My Personal Health Guide on >80% ART adherence at 1-month follow-up.
Results:
The sample for analysis of My Personal Health Guide app efficacy was 131 (76 intervention: 55 control). The odds of being >80% adherent to ART at 1-month follow-up was 3.97 times greater (95% CI: 1.26, 12.55) among participants randomized to the My Personal Health Guide app compared to the controls, after adjusting for ART adherence at baseline, treatment adherence self-efficacy, and ever being incarcerated.
Conclusions:
Participants randomized to receive My Personal Health Guide reported nearly four times greater odds of being >80% adherent to ART compared to the attention control group at 1-month follow-up. To our knowledge, this is the first RCT demonstrating improved medication adherence using a relational agent-based behavioral intervention. These findings provide evidence of short-term efficacy of My Personal Health Guide to improve ART adherence among young AAMSM. Clinical Trial: ClinicalTrials.gov ID NCT04217174
Citation
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