EXECUTIVE SUMMARY

Researchers have recently secured funding to develop mobile technology apps that aim to increase HIV testing and use of and adherence to pre-exposure prophylaxis to prevent HIV among young people.

  • Youth ages 13-24 account for more than one in five new HIV diagnoses in the United States. Data from the Youth Risk Behavior Surveillance System indicate just 22% of high school students who had ever had sexual intercourse have been tested for HIV.
  • Surveys show that digital technology, including the internet, mobile phones, and gaming, are part of young people’s daily lives. Among those aged 12-17, 93% have online access, 75% have a mobile phone, and 97% play video games.

According to the latest statistics, youth ages 13-24 account for more than one in five new HIV diagnoses in the United States.1 Data from the Youth Risk Behavior Surveillance System, which monitors health risk behaviors that contribute to the leading causes of death and disability among youth, indicate just 22% of high school students who had ever had sexual intercourse had been tested for HIV. 2

Researchers have recently secured funding to develop mobile technology apps that aim to increase HIV testing, and use of and adherence to pre-exposure prophylaxis (PrEP) to prevent HIV among young people. For those who test positive for the virus, scientists plan to develop electronic health interventions to engage them in care and improve adherence to antiretroviral therapy.

“Despite recommendations that high-risk youth receive an HIV test at least annually, many young men who have sex with men have not been tested in the last year, and more than half of youth with HIV are unaware of their infection,” says Lisa Hightow-Weidman, MD, MPH, associate professor of medicine and principal investigator of the Behavior and Technology Lab at the University of North Carolina at Chapel Hill. Barriers to testing among youth include misperception of individual risk, fear of testing positive, concerns about confidentiality, and access to healthcare services, she notes.

Hightow-Weidman and Patrick Sullivan, PhD, DVM, professor of epidemiology in the Rollins School of Public Health at Emory University, will lead research teams to form the UNC/Emory Center for Innovative Technology, or iTech. The project has secured $18 million in funding over the next five years from the National Institutes of Health.

The iTech project will include six research studies, with each study using technology to address a barrier to the HIV care continuum, said Hightow Weidman in a media statement. For youth at risk of becoming infected with HIV, the research team will develop apps that aim to increase HIV testing and use of and adherence to PrEP to prevent HIV. For those who test positive for the virus, scientists will create electronic health interventions to engage youth in care and improve adherence to antiretroviral therapy.

Reaching the Technology Generation

Surveys show that digital technology, including the internet, mobile phones, and gaming, are part of young people’s daily lives. Among those aged 12-17, 93% have online access, 75% have a mobile phone, and 97% play video games.34

While technology allows young people to engage in age–old behaviors such as chatting, flirting, and dating in novel ways, it also provides them anonymous avenues for seeking health information in general and sexual health in particular.

Young men who have sex with men represent a particularly vulnerable population. Gay and bisexual men ages 13 to 24 accounted for an estimated 92% of new HIV diagnoses among all men in their age group, and 27% of new diagnoses among all gay and bisexual men.1

If researchers can find a website or a mobile app that is effective in helping young gay and bi men reduce their risk of HIV, then a high number at-risk men can be reached at a low incremental cost, observes Sullivan.

Collaboration is Key

The iTech project is just part of a National Institutes of Health-funded research network devoted to the health and well-being of adolescents and young adults with HIV or at risk for HIV infection. The federal agency awarded some $24 million in 2016 to provide for three research centers and a data coordinating center to make up the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN).

The purpose of the network is to get at-risk youth into care, while at the same time offering them the opportunity to participate in research trials that have the potential to improve their health and the health of others, says Bill Kapogiannis, MD, network co-director and medical officer at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the NIH institute providing much of the funding for the awards.

The ATN centers will perform research aimed at preventing HIV infection among youth, and also will seek to enroll HIV-infected youth into treatment studies to improve their health and prevent transmission to others.

Many at-risk youths are not aware that they need HIV and STI testing or prevention services, observes Sonia Lee, PhD, network co-director and NICHD program officer. The network’s studies will focus on helping this population engage with available services and avoid behaviors that increase the risk of HIV infection.

Other principal investigators involved in the network include Mary Jane Rotheram-Borus, PhD, at the University of California, Los Angeles; Sylvie Naar-King, PhD, at Wayne State University, Detroit; Bonita Stanton, PhD, at Seton Hall University, South Orange, NJ; and Jeffrey Parsons, PhD, Hunter College, New York City.

Use Existing Technology

Providers can use existing technology to help young people learn more about their HIV status and HIV prevention. The CDC has developed the “Doing It” national HIV testing and prevention campaign designed to motivate all young people and adults to get tested for HIV and know their status. As part of the Act Against AIDS initiative, “Doing It” delivers the message that HIV testing should be a part of everyone’s regular health routine to keep ourselves and our community healthy. (Visit the website at http://bit.ly/1PWhadW.)

Direct young people to use the HIV/AIDS Prevention & Service Provider Locator, a location-based search tool that allows them to search for service providers for HIV testing, housing assistance, health centers, Ryan White HIV Care services, mental health, substance abuse, and family planning. (Click on “Locator” at http://bit.ly/1CAfFpz.)

REFERENCES

  1. Centers for Disease Control and Prevention. HIV Surveillance Report, 2014; accessed at http://bit.ly/2dRJIH3.
  2. Kann L, Kinchen S, Shanklin SL, et al; Centers for Disease Control and Prevention (CDC). Youth risk behavior surveillance--United States, 2013. MMWR Suppl 2014; 63(4):1-168.
  3. Lenhart A, Ling R, Campbell S, et al. Teens and Mobile Phones. Washington, DC; 2010.
  4. Lenhart A, Kahne J, Middaugh E, et al. Teens, Video Games, and Civics. Washington, DC: Pew Internet & American Life Project; 2008.