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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Jan 9, 2026
Date Accepted: May 19, 2026
Date Submitted to PubMed: May 19, 2026

The final, peer-reviewed published version of this preprint can be found here:

A Web-Based Virtual Environment Behavioral Intervention as Cardiovascular Disease and Metabolic Disease Prevention Education in Persons With HIV: Evaluation of the LEARN Randomized Controlled Trial

Ramos SR, Boerger L, Restar AJ, Phadke M, Jeon S, Johnson C, Melkus G, Kershaw T, Reynolds H, Vorderstrasse A

A Web-Based Virtual Environment Behavioral Intervention as Cardiovascular Disease and Metabolic Disease Prevention Education in Persons With HIV: Evaluation of the LEARN Randomized Controlled Trial

J Med Internet Res 2026;28:e91145

DOI: 10.2196/91145

PMID: 42154285

A Web-based Virtual Environment Behavioral Intervention as CVD and Metabolic Disease Prevention Education in Persons with HIV: Evaluation of the LEARN RCT

  • S. Raquel Ramos; 
  • Lindsie Boerger; 
  • Arjee J. Restar; 
  • Manali Phadke; 
  • Sangchoon Jeon; 
  • Constance Johnson; 
  • Gail Melkus; 
  • Trace Kershaw; 
  • Harmony Reynolds; 
  • Allison Vorderstrasse

ABSTRACT

Background:

Persons with HIV have an increased risk of cardiovascular and metabolic diseases compared to HIV serostatus-negative individuals.

Objective:

We conducted a pilot wait-list control randomized trial to assess the feasibility and acceptability of a virtual environment for CVD and metabolic disease prevention education in men living with HIV.

Methods:

In phase one, we conducted interviews and virtual environment beta testing with (n=25) individuals. In phase two, reported here, we conducted a wait-list control trial with permuted block randomization. Participants were allocated to the virtual environment intervention (n = 40) or a wait-list control arm (n = 38). The primary outcomes were feasibility (defined by recruitment and retention metrics) and acceptability (defined by levels of engagement) with virtual environment. We also examined preliminary effect sizes across several cardiovascular health-related indicators.

Results:

The LEARN Study demonstrated the feasibility and acceptability of a virtual environment designed for cardiovascular and metabolic disease prevention education in persons with HIV. The high engagement rates with specific educational content and strong retention highlight the promise of this innovative approach. Preliminary effect sizes suggested positive trends in cardiovascular health indicators and mental well-being, indicating further potential benefits of the intervention. These findings support progression to a fully powered randomized controlled trial. Subsequent funding has been awarded, based on this work, to expand the research in LEARN2. We will integrate lessons learned and focus on HIV- related conditions with shared risk factors to enhance the study’s impact. By addressing HIV conditions with interrelated risk factors, we aim to provide a more comprehensive intervention to improve the overall health and well-being of individuals living with HIV.

Conclusions:

The LEARN Study demonstrated the feasibility and acceptability of a virtual environment designed for cardiovascular and metabolic disease prevention education in persons with HIV. The high engagement rates with specific educational content and strong retention highlight the promise of this innovative approach. Preliminary effect sizes suggested positive trends in cardiovascular health indicators and mental well-being, indicating further potential benefits of the intervention. These findings have significant implications for developing technology-driven interventions to improve health outcomes in groups underrepresented in research. Subsequent funding has been awarded, based on this work, to expand the research. We will integrate lessons learned and focus on HIV- related conditions with shared risk factors to enhance the study’s impact. By addressing HIV conditions with interrelated risk factors, we aim to provide a more comprehensive intervention to improve the overall health and well-being of individuals living with HIV. Clinical Trial: ClinicalTrials.gov NCT05242952


 Citation

Please cite as:

Ramos SR, Boerger L, Restar AJ, Phadke M, Jeon S, Johnson C, Melkus G, Kershaw T, Reynolds H, Vorderstrasse A

A Web-Based Virtual Environment Behavioral Intervention as Cardiovascular Disease and Metabolic Disease Prevention Education in Persons With HIV: Evaluation of the LEARN Randomized Controlled Trial

J Med Internet Res 2026;28:e91145

DOI: 10.2196/91145

PMID: 42154285

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