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Publication Profiles

Optimal strategies to improve uptake of and adherence to HIV prevention among young people at risk for HIV acquisition in the USA (ATN 149): a randomised, controlled, factorial trial

Citation

Swendeman D, Rotheram-Borus MJ, Arnold EM, et al. Optimal strategies to improve uptake of and adherence to HIV prevention among young people at risk for HIV acquisition in the USA (ATN 149): a randomised, controlled, factorial trial. Lancet Digit Health. 2024;6(3):e187-e200. doi:10.1016/S2589-7500(23)00252-2

Implementation stage:

Implementation

Implementation outcomes reported:

Not applicable

Continuum target addressed:

Linkage to preventative care, PrEP initiation, PrEP adherence

Geography:

Los Angeles County-CA,Orleans Parish-LA

Study Participant Classification:

Recipients of care

Plain Language Objectives

The researchers tested different combinations of text messages, online peer support, and telehealth coaching to learn whether they helped young people use HIV prevention options more consistently.

Plain Language Abstract

Young people at risk of HIV often have low uptake of pre-exposure prophylaxis, or PrEP, and other prevention options. Researchers conducted a four-group randomized trial in Los Angeles and New Orleans. Of 2,314 screened, 1,037 participants aged 16–24 enrolled, and 895 completed follow-up and were analyzed. Everyone received automated messages; groups also received online peer support, telehealth coaching, or both. Participants were followed for 24 months. Current PrEP use rose from 11% at baseline to 15% at four months. The group receiving both peer support and coaching continued to increase PrEP use compared with messaging alone (odds ratio 2.31; 95% confidence interval, 1.28–4.14). Researchers found no intervention effect on condom use, post-exposure prophylaxis, PrEP adherence, or number of partners. No unexpected or study-related adverse events occurred. The authors interpreted the combined approach as promising for PrEP uptake, while noting that it did not improve every prevention outcome and that implementation would need adaptation to local settings.

Key Takeaways

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