The Feasibility and Acceptability of Using Technology-Based Daily Diaries with HIV-Infected Young Men Who have Sex with Men: A Comparison of Internet and Voice Modalities

Abstract

This study delivered a daily diary to 67 HIV-infected men who have sex with men (MSM) between 16 and 24 years old for 66 days to measure HIV-risk behaviors and other psychosocial variables via two diary modalities: internet (accessible via any web-enabled device) and voice (accessible via telephone). Participants were randomized to complete one diary modality for 33 days before switching to the second modality for 33 days. The study was implemented in three urban HIV health care centers in the United States where participants were receiving services. Through diary data and qualitative interview data, we examined the feasibility and acceptability of the dairies and identified barriers and facilitators of dairy compliance. Results show high participant retention in the daily diary (93.4%) and high compliance for the number of dairies completed (72.4%). Internet diaries were preferred by 92% of participants and completed at a significantly higher rate (77.5%) than voice diaries (67.7%). Facilitators included opportunities for self-reflection and cathartic sharing, monetary compensation, relationships with study staff, and daily reminders. Barriers included being busy or not having privacy at the time of reminders, forgetting, and falling asleep. Participants also described barriers and facilitators unique to each modality. Overall, both modalities were feasible and acceptable for use with our sample of HIV-infected MSM.

Social Inequity and Structural Barriers to Completion of Ecological Momentary Assessments for Young Men Who Have Sex With Men and Trans Women Living With HIV in San Francisco

“…Previous studies have used the terms “daily diaries” or “electronic diaries” interchangeably with EMAs; however, in this study, we will use only EMA for consistency. A range of research projects have used EMAs to improve data accuracy and to capture nuances in affect or mood [1], substance use [1-5], and, more recently, behaviors among persons living with HIV [5-8].…”

“…In a study of young, black MSM, researchers concluded that mobile HIV interventions may increase participation in HIV prevention and treatment [13]. One study of young MSM living with HIV showed high feasibility and acceptability of daily diaries measuring affect, substance use, and other risk behaviors [8]. Another study found acceptability of a peer-administered mobile health intervention among persons living with HIV who also had a history of substance use disorders and low adherence to antiretroviral treatment [5].…”

“…However, to our knowledge, no quantitative studies of EMAs or other mobile health interventions exist for TW. Just as young MSM and other HIV risk groups consistently demonstrate high EMA compliance [1,2-4,8,15], TW living with HIV may similarly respond well to such a data collection method.…”

Health Technology-Enabled Interventions for Adherence Support and Retention in Care Among US HIV-Infected Adolescents and Young Adults: An Integrative Review

“…Yet nearly 60% of youth initiating ART are not retained in care [3], thereby impairing access to HIV medications and increasing risk for ART resistance [9], treatment failure [9, 10], patient mortality [11, 12], and sexual transmission to seronegative partners [13, 14]. To date, technology-enabled interventions have shown promise for a range of chronic conditions [15], including HIV-in-fected adolescent, young adult, and adult cohorts from domestic and international settings [16–21]. However, much less is known about the impact of health technology-enabled interventions on the HIV care cascade [22] with significant knowledge gaps in research targeting ART adherence and retention outcomes among HIV-infected youth [23].…”

Event-Level Association Between Daily Alcohol Use and Same-Day Nonadherence to Antiretroviral Therapy Among Young Men Who Have Sex With Men and Trans Women Living With HIV: Intensive Longitudinal Study

“…EMA is a real-time data collection technique administered via technological platforms, such as handheld devices or mobile phones. A number of previous studies have used EMAs to capture fine-grained variations in substance use [ 28 - 31 ] and, more recently, behaviors among people living with HIV [ 28 , 32 - 34 ]. A number of studies have shown that EMA is feasible and acceptable among MSM [ 34 - 37 ] and persons who use substances [ 28 , 29 ]; one study showed moderate compliance to EMA among young MSM and TW living with HIV [ 38 ].…”