Designing an application that assists healthcare providers and people with HIV to improve medication adherence.

The Centers for Disease Control (CDC) estimates that approximately 50,000 Americans become infected with HIV annually, and the number of people living with HIV in the United States is now nearly 1.2 million. As this number continues to grow by tens of thousands each year, this creates more opportunities for HIV transmission. Public health advocates are marshalling efforts to prevent new infections from happening.

The CDC has published an online toolkit called Every Dose, Every Day. This toolkit assists healthcare providers and people with HIV to improve medication adherence, a key strategy for reducing new HIV cases. Two Boston-based companies, Mad*Pow and John Snow, Inc. (JSI), played a major role in bringing this toolkit to the public health arena.

The Every Dose, Every Day toolkit features a social marketing campaign, e-learning modules for providers, and a mobile treatment application for people living with HIV. These interventions help providers assess and manage patient adherence, while also establishing a trusting relationship with patients to help find solutions to any barriers. These interventions have shown efficacy in improving adherence among both those who have never used antiretroviral therapy (ART) and those who are ART-experienced.

The project required Mad*Pow and JSI to partner and take advantage of each others’ strengths to deliver an effective solution. Mad*Pow designed and executed a research study to understand why some folks living with HIV take their medication and why some folks don’t. Mad*Pow oversaw a nine- month study that included interviewing people living with HIV, clinicians and case workers. Based on the findings from the research, Mad*Pow took the behavioral insights to design an application to help folks who were not taking their medication regularly. These insights were essential to designing an application that was both evidence-based and person-centered, to maximize acceptance, usage and effectiveness.

JSI acted in a central role, overseeing the project and bringing a depth of HIV experience and longstanding relationships with the HIV community both locally and nationally. In particular, JSI’s role was to translate an intervention (using 2-way text paging) into something relevant and appealing to a modern audience. The app, created to update the paging module, has been downloaded more than 500 times since the CDC released it last Fall.
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