Intersection of Technology, HAART Adherence, and Drug Abuse Treatment

United States

The NIDA AIDS Research Program convened a 2-day meeting in Washington, DC. The purpose of the meeting was to encourage multidisciplinary collaboration between social scientists, medical researchers (doctors and nurses), and technology experts to develop and refine mobile technological instrumentation, e-health technology, and software as interventions to foster adherence to HIV treatment regimens and access to care among substance-abusing populations.

Purpose:

• Encourage collaboration between social scientists, medical researchers, and technology experts to explore the use of mobile technology to foster adherence to HIV treatment regimens and access to care among substance-abusing populations

Topics Discussed:

• How feasible is it to develop, utilize, implement, and disseminate these technologies?
• What are the potential barriers to adopting these approaches?
• Which technological approaches are the most likely candidates for efficaciously promoting HAART adherence?

Fundamental Take-Home Messages from Talks/ Group Discussions

• Technologies become outdated very quickly. Therefore, crucial to understand the underlying principles behind the interventions
• Leveraging the core essential elements of evidence-based interventions offer the possibility of wide dissemination through technology
  • Adapting interventions to target defined subpopulations (e.g., cognitively impaired substance user) will allow for greater intervention specificity
• To what degree does NIDA/NIH need to start more strongly mandating for open source and interoperable platforms (at a minimum) for federally funded projects?
• Cooperation across sites (minimally) and/or cooperative agreements to support infrastructure for technological intervention development and dissemination efforts (P20s)
• Unprecedented opportunities to intervene in real time and during everyday daily routines and in high-risk situations
• Identifying "science of delivery"/ "implementation science":
  • How to deliver and frame interventions in a maximally effective way?
  • Develop and deliver interventions that are effective across settings (e.g., community health agency, HIV primary clinic, prison)
  • Recognizing the tension between the academic model (incremental) vs. dissemination model (getting product to market for scale-up)

Technology-Based Adherence Interventions for Substance Abusing Populations HIV (R01, with PAS-10-097 & R34, PAS-10-098)

• Purpose: Stimulate research on the determination of feasibility, and pilot testing of development, interventions that utilize technological tools to foster adherence to HIV treatment regimens among substance abusing populations in naturally occurring timeframes
• Funds Available and Anticipated Number of Awards: $1.5 million total costs in FY 2010 and $1.5 million in FY 11 to support 6-9 new projects under this FOA and the accompanying R01 FOA
• Opening Date: April 7, 2010/AIDS Application Due Dates

Presentations

Intersection of Tech and HIV Adherence Meeting Summary (PDF, 141 KB)
Shoshana Y. Kahana, Ph.D.
Program Official
Behavioral and Integrative Treatment Branch
Division of Clinical Neuroscience and Behavioral Research
National Institute on Drug Abuse 
Bethesda
MD 20892-9593

Slide Presentations

Highly Active Antiretroviral Therapy and Survival in HIV-Infected Injection Drug Users: Implications for the Critical Role of Adherence (PDF, 918 KB)
Robert S. Hogg, Ph.D.
Simon Fraser University/BC Centre for Excellence in HIV/AIDS 
Vancouver, British Columbia, Canada

Interventions Targeting Medication Adherence and Drug Use for HIV+ Men: Perspectives from an Academic/Outpatient Clinic (PDF, 1.27 MB)
Jeffrey T. Parsons, Ph.D.
Co-Director, Center for HIV/AIDS Educational Studies and Training
Hunter College
New York, NY

Interventions Targeting Medication Adherence and Drug Use for HIV+ Criminal Justice Populations (PDF, 775 KB)
Frederick L. Altice, M.D., and Sandra Springer, M.D.
School of Medicine, Yale University 
New Haven, CT

Considerations for Continued Development of Behavioral Interventions Targeting HIV Treatment Adherence (PDF, 370 KB)
Gregory M. Lucas, M.D., Ph.D.
Division of Infectious Diseases
Johns Hopkins University School of Medicine
Baltimore, MD

Self-Monitoring Applications and Implications for Interventions Targeting Drug Abuse and HIV Treatment Adherence (PDF, 3.89 MB)
Mary Jane Rotheram-Borus, Ph.D.
Center for HIV Identification, Prevention, and Treatment Services
University of California at Los Angeles
Los Angeles, CA

Real-Time Electronic Diary Reports of Cue Exposure, Mood, and Drug Use (PDF, 2.31 MB)
Kenzie L. Preston, Ph.D.
Intramural Research Program
National Institute on Drug Abuse 
Baltimore, MD

Novel Approaches to Monitoring Adherence to HIV Therapy (PDF, 578 KB)
Jessica E. Haberer, M.D.
Massachusetts General Hospital
Boston, MA

Impact of Frontline SMS, Mobile Phones, and Text Messaging on Health Care Delivery in Rural Malawi (PDF, 7.53 MB)
Josh Nesbit
FrontlineSMS:Medic \+/
Washington, DC

The Development of a Web-Based Program to Improve Adherence to HIV/AIDS Medications among Drug Abusers in a Community Clinic (PDF, 82 KB)
Royer F. Cook, Ph.D.
ISA Associates, Inc.
Arlington, VA

CFAR Network of Integrated Clinical Systems (CNICS): The Use of Real-Time Patient-Centered Clinical Metrics for Substance Abuse and HIV Care (PDF, 1.46 MB)
Stephen L. Boswell, M.D.
Fenway Health/Harvard Medical School
Boston, MA

Collaboration with Developers: A Two-Way Learning Experience (PDF, 1.02 MB)
Vesta Brue
Inventor and Lead Developer, MedSignals LLC 
San Antonio, TX

Creating a Shared, Open, and Scalable Platform for Intervention Innovation (PDF, 769 KB)
Deborah Estrin, Ph.D. 
Director, Center for Embedded Networked Sensing 
University of California Los Angeles
Los Angeles, CA

Future Considerations and Lessons Learned from Internet-Based Interventions for HIV/STI Prevention
Lisa A. Marsch, Ph.D. 
National Development and Research Institute 
New York, NY

Substance Use, ART Adherence, and the Development of Class-Specific Antiretroviral Resistance: Implications for Future Interventions (PDF, 230 KB)
Edward M. Gardner, M.D. 
University of Colorado at Denver 
Denver Public Health
Denver, CO

Small Business Innovation Research (SBIR) and Technology Transfer (STTR) Programs (PDF, 867 KB)
Cathrine A. Sasek, Ph.D. 
Office of Science Policy and Communications 
National Institute on Drug Abuse
Bethesda, MD

Fostering Public Partner Partnerships (PDF, 755 KB)
Shawnmarie Mayrand-Chung, Ph.D.
Public-Private Partnership Program, Office of Science Policy
National Institutes of Health
Bethesda, MD