How a smartphone app is helping suppress HIV

Young men who used the HIV app were more likely to take their medications.

May 13, 2021

A mobile game designed to motivate people to take their HIV medications was able to increase viral suppression rates in a small study — suggesting that gamification could help HIV-positive people live longer, healthier lives.

The challenge: In 1996, a 20-year-old with HIV had a life expectancy of 39 years. Today, people with HIV can expect to live almost as long as anyone else — if they commit to antiretroviral therapy (ART) soon after their diagnosis.

ART is a combination of drugs that make it hard for the HIV virus to replicate. If the amount of HIV in a person’s body drops low enough, the virus is considered “suppressed.” Suppressing the virus stops the disease from progressing, as well as preventing transmission.

Viral suppression is closely linked to a longer, healthier life for people with HIV, but for ART to be most effective, it must be taken every single day.

Many people do not stick to their treatment regimen, though, and commonly cited reasons include forgetfulness, a lack of social support, and a subpar understanding of how the drugs work and their benefits.

The HIV app: To motivate people living with HIV to take their medication, researchers at Duke University and the University of North Carolina at Chapel Hill created a mobile app called Epic Allies.

The app works like a scheduler for HIV medications, allowing users to set reminders and track when they actually take their drugs — but it also incorporates gaming elements to motivate them to stick to their regimen.

There are even social media features they can use to encourage and congratulate each other.

Gaming for science: To test the efficacy of their app, the researchers conducted a trial with 146 HIV-positive men between the ages of 16 and 24.

All of the participants downloaded the HIV app, but only some received daily reminders to take their medications and customized feedback and encouragement.

Apps and digital tools are a bridge to care.

Lisa Hightow-Weidman

After 26 weeks, 73.5% of people in the experimental group had achieved viral suppression compared to only 62.9% in the control group who did not use the gaming app.

Participants who used the HIV app four or more times per week were more than twice as likely to report near-perfect adherence to their ART regimen. They were also 50% more likely than people who didn’t use the app as often to achieve viral suppression 13 weeks after starting the trial.

The cold water: The study was small, and only included young men, so we don’t know if other demographics would achieve the same success.

It’s also impossible to say whether anyone would stick with the app long term, and people living with HIV must commit to ART for the rest of their lives.

However, other apps have demonstrated that gamifying a medical regimen can help patients to stick to it — and now this one suggests that the same could be true for people living with HIV.

“Apps and digital tools are a bridge to care,” study author Lisa Hightow-Weidman said in a press release. “They cannot replace a network of doctors and nurses and care management, but they can be a bridge to that real world and inspire change.”

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