Challenges and Opportunities for HIV Prevention and Care: Insights From Focus Groups of HIV-Infected African American Men

BACKGROUND Avatars and embodied agents are a promising innovation for human health intervention because they may serve as a relational agent that might augment user engagement in a behavioral change intervention and motivate behavioral change such as antiretroviral adherence and retention in care. OBJECTIVE This study aimed to develop a theory-driven talking avatar-like embodied agent mobile phone intervention guided by the information-motivation-behavioral skills model to promote HIV medication adherence and retention in care in young African American men who have sex with men (MSM). METHODS We performed 5 iterative focus groups in Chicago with HIV-positive African American MSM aged 18-34 years to inform the ongoing development of a mobile phone app. Participants for the focus groups were recruited from 4 University of Illinois at Chicago Community Outreach Intervention Project sites located in different high HIV incidence areas of the city and the University of Illinois at Chicago HIV clinic using fliers and word of mouth. The focus group data analysis included developing an ongoing list of priorities for app changes and discussion between two of the investigators based on the project timeline, resources, and to what extent they served the app’s objectives. RESULTS In this study, 16 men participated, including 3 who participated in two groups. The acceptability for an embodied agent app was universal in all 5 focus groups. The app included the embodied agent response to questions and antiretroviral regimen information, adherence tracking, CD4 count and viral load tracking, motivational spoken messages, and customizability. Concerns that were identified and responded to in the development process included privacy, stigma, avoiding the harsh or commanding tone of voice, avoiding negative motivational statements, and making reminder functions for a variety of health care interactions. CONCLUSIONS An avatar-like embodied agent mHealth approach was acceptable to young HIV-positive African American MSM. Its relational nature may make it an effective method of informing, motivating, and promoting health behavioral skills. Furthermore, the app’s ease of access, stigma-free environment, and audiovisual format may help overcome some adherence barriers reported in this population.

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Reaching African-American Men on the “Down Low”: Sampling Hidden Populations: Implications for HIV Prevention

Journal of Homosexuality ◽

10.1080/00918360802345198 ◽

2008 ◽

Vol 55 (3) ◽

pp. 437-449 ◽

Cited By ~ 11

Author(s):

Larry D. Icard

Keyword(s):

African American ◽

Hiv Prevention ◽

African American Men ◽

Hidden Populations ◽

Down Low

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Evaluating the Feasibility of Implementing an HIV Prevention Intervention for Incarcerated African American Men: Lessons Learned From a Pilot Study

Health Promotion Practice ◽

10.1177/1524839919896786 ◽

2020 ◽

Vol 21 (5) ◽

pp. 822-830

Author(s):

Carlos C. Mahaffey ◽

Danelle Stevens-Watkins ◽

A. Kathleen Burlew ◽

Myles D. Moody ◽

Paris B. Wheeler ◽

...

Keyword(s):

African American ◽

Pilot Study ◽

Hiv Prevention ◽

African American Men ◽

Setting Time ◽

Lessons Learned ◽

Future Research ◽

Prison Setting ◽

Hiv Intervention ◽

Culturally Adapted

This pilot study evaluated the feasibility of implementing an evidence-based, culturally adapted HIV intervention with substance-using African American men in a prison setting. We recruited 60, soon-to-be released African American male prisoners from a larger study ( N = 211) to be randomly selected for participation in the group-based HIV intervention, Real Men Are Safe–Culturally Adapted (REMAS-CA). Participants who were not selected for participation in the intervention received standard Centers for Disease Control and Prevention HIV prevention counseling education, provided during participant assessment in the larger study. Nearly all of the participants who were selected to participate (87%) completed the REMAS-CA intervention. To examine feasibility, data were collected about any revisions made to the HIV intervention components for the prison setting, time needed to implement the program in full, details of implementing the intervention to ensure participation and maintain retention, and participant perception of the intervention. Revisions to the intervention included reducing the number of sessions from five to three, modifying the protocol language based on the setting, and removing six activities deemed inappropriate and/or unallowable by the prison officials. The cultural considerations and intervention, overall, were well received by the participants. However, several revisions made specific to the prison and its administration could affect the potential effectiveness of the intervention. Future research is needed to determine the effectiveness of REMAS-CA among this community.

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