Researchers from the University at Buffalo (UB) in the US found that participants not only found the app easy and convenient to use – they were also willing to provide honest responses about substance use.
“Reporting was actually high – we had 95 per cent compliance with daily report completion. A key finding of our study was the ability for people living with HIV to feel comfortable reporting on sensitive health behaviors,” said Sarahmona Przybyla, assistant professor at UB’s School of Public Health and Health Professions.
A willingness to report the use of alcohol or drugs was significant because substance use is one of the most reliable predictors of poor adherence to antiretroviral therapy (ART), researchers said.
The findings were more surprising considering that the majority of the 26 study participants had never used a smartphone before. After some initial smartphone training from research staff, they completed their reports with ease.
Participants were asked to use the app – named Daily Reports of Using Medications (DRUM) – to complete their reports, which took three to five minutes, between 4 pm and 6 pm each day for two weeks.
Every afternoon, the 26 study participants received a text message reminder asking them to fill out their report.
Researchers were deliberate in their wording of the questions.
“People living with HIV continue to be a stigmatised population, so we didn’t want any of the questions we developed to draw attention to their disease,” said Przybyla.
“We never used ‘HIV’ or ‘ART’ – anything that would inadvertently out someone as having HIV,” said Przybyla.
A change in daily routine was the most commonly reported reason participants did not take their medication, followed by simply forgetting. Use of alcohol or drugs was the third most common reason.
Participants who confirmed they had used alcohol or drugs in the past 24 hours were given a series of follow-up questions that asked why they used the substance and where they were when they used it.
In the future, the app could aid in users’ decision to use alcohol since some participants in this study reported that it helped them understand exactly how much they were drinking.
“I think the surprising thing is how much the app and the text reminders helped the participants to develop a routine,” said Rebecca Eliseo-Arras, senior research analyst at UB’s Research Institute on Addictions.
“For instance, some reported that the text message reminded them to do the report, but the report actually made them think about whether or not they took their medication and, if they didn’t, that it prompted them to go take their medications,” said Eliseo-Arras.
The research was published in the journal AIDS Research and Treatment.
PTI