A Waiting Room-Delivered Video to Enhance Clinical Outcomes Among Persons Living With HIV

The overall goal of this study is to beta-test the waiting room video in three HIV/AIDS treatment facilities in different US jurisdictions with high AIDS prevalence. These results will be used to refine the video and to increase its effectiveness among minority persons living with HIV infection. The beta-testing will consist of: 1) unobtrusive observations of waiting room patients for one day at each facility and 2) de-identified, existing patient medical data abstracted from each facility's electronic medical record (EMR) system to investigate outcomes relevant to HIV medication adherence and retention in care.

• Taking Care of Me Video (Other): The video's conceptual framework incorporates Social Cognitive Theory, Information-Motivation-Behavioral Skills model, and Social Action Theory, which together address cognitive and behavioral factors related to study outcomes. Storylines embedded prevention messages aimed at increasing treatment initiation (n=9), medication adherence (n=35), retention in care (n=22), partner protection (n=12), and communication with health care providers (n=7).

Primary outcomes

• Antiretroviral therapy (ART) medication adherence (suppression level) [By 6 months (183 days) after the patient's index (first) visit to the clinic]: Adherence was measured by whether viral load suppression (<200 RNA copies/mL) was achieved
• Antiretroviral therapy (ART) medication adherence (undetectable level) [By 6 months (183 days) after the patient's index (first) visit to the clinic]: Adherence was measured by whether viral load suppression (<50 RNA copies/mL) was achieved

Secondary outcomes

• Treatment initiation [on, before, or within 7 days after, their index visit, as documented by OAMC visits in patient EMRs.]: Treatment initiation was measured by a patient's receipt of an ART prescription
• Retention in HIV medical care [2 or more clinic visits for any reason at least 90 days apart in the past year divided by all active clients who had had at least one such visit in the past year]: Measured by an adaptation of the Health Resources and Services Administration's (HRSA) definition in the Annual Ryan White HIV/AIDS Program Services Report

Sex: All, ages: 18 Years to 87 Years

Inclusion Criteria:

HIV/AIDS treatment facility inclusion: The participating treatment facilities will have a combined total of at least 2,700 monthly patient visits during the study period. Each of the HIV/AIDS treatment facilities meets the following inclusion criteria:

1. located in a jurisdiction with high AIDS prevalence;
2. managing more than 500 unique HIV-positive patients annually;
3. serving minority persons such that minimally 55% of the clinic population is African-American and Hispanic/Latino;
4. at least 163 patients have unsuppressed viral load;
5. utilizing an electronic medical record (EMR) system; and
6. not participating in another behavioral intervention research project during the historical comparison data period (August 2015 through May 2016) or during the 10-month intervention period (June 2016 through March 2017).

Exclusion Criteria:

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• Results publication: Neumann MS, Plant A, Margolis AD, Borkowf CB, Malotte CK, Rietmeijer CA, Flores SA, O'Donnell L, Robilotto S, Myint-U A, Montoya JA, Javanbakht M, Klausner JD. Effects of a brief video intervention on treatment initiation and adherence among patients attending human immunodeficiency virus treatment clinics. PLoS One. 2018 Oct 5;13(10):e0204599. doi: 10.1371/journal.pone.0204599. eCollection 2018. PMID 30289884

• Mary S. Neumann, PhD, Principal investigator, Centers for Disease Control and Prevention
• Aaron Plant, MPH, Principal investigator, Sentient Research