Use of technology for delivery of mental health and substance use services to youth living with HIV: a mixed-methods perspective
Open accessAbstract
Disparities in HIV treatment outcomes among youth living with HIV (YLWH) present a challenge for ending the HIV epidemic. Antiretroviral therapy (ART) adherence can be impacted by comorbidities such as mental health and substance use. Technology use has shown promise in increasing access to mental health and substance use services. Using a mixed-methods approach, we conducted formative research to describe the relationship between mental health, substance use, and medication adherence in 18-29 year-old YLWH, and explored technology use as an approach to supporting these services. Among 101 YLWH, ART adherence was significantly negatively associated with mental health measures such as depression, trauma, and adverse childhood experiences and marijuana and stimulants use. Depression had the highest level of relative importance in its association with ART adherence. During in-depth interviews with 29 participants, barriers to and facilitators of accessing and maintaining mental health services were identified. Most participants favored technology use for mental health and substance use service delivery, including videoconferencing with a counselor. Provision of ongoing mental health and substance use treatment is an important mechanism to achieving HIV treatment engagement. Technology, particularly videoconferencing, may have the capacity to overcome many barriers to care by increasing accessibility of these services.
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In 3 studies, participants mentioned that it was challenging to find a private space at home or work to use an intervention, which formed a barrier to engaging with it.
“In 3 studies, participants mentioned that as opposed to going to a health care provider office, it was challenging to find a private space at home or work to use an intervention, which formed a barrier to engaging with it [136-138].”
From Barriers to and facilitators of user engagement with digital mental health interventions: Systematic review (2021) · cites this paper as [136]
The Results (Qualitative Results, page unavailable) identify a lack of private space to talk as a potential barrier to videoconferencing with a counselor. The Discussion likewise calls it a barrier, but neither passage specifies home or work or frames the difficulty as a contrast with going to a provider’s office. The count of three studies refers to the group of citations, not to this source alone. (LLM, conf=0.85)
Experimental — accuracy not yet measuredStudy participants evaluating an app that delivered remote web-based therapy felt that they could disclose more in a closed therapist office than through a web-based intervention at home where other people in their household could see or disrupt them.
“For example, study participants evaluating an app that delivered remote web-based therapy felt that they could disclose more in a closed therapist office than through a web-based intervention at home where other people in their household could see or disrupt them [136].”
From Barriers to and facilitators of user engagement with digital mental health interventions: Systematic review (2021) · cites this paper as [136]
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BackgroundSaberi, P., McCuistian, C., Agnew, E., Wootton, A. R., Legnitto Packard, D. A., Dawson-Rose, C., Johnson, M. O., Gruber, V. A., & Neilands, T. B. (2021) · Telemedicine Reports · doi:10.1089/tmr.2020.0014 · Cited by 30 · see citing works
“For example, YLWH experience high rates of mental health symptoms(5) and limited access to mental health treatment.(6) Mental health symptoms such as depression can further exacerbate disparities related to HIV care retention and adherence.”
BackgroundSelf-citation
- Authors
- Saberi, P., Dawson Rose, C., Wootton, A. R., Ming, K., Legnitto, D., Jeske, M., Pollack, L. M., Johnson, M. O., Gruber, V. A., & Neilands, T. B.
- Affiliations
- University of California, San Francisco (US)
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, CA, USA
- Corresponding author
- Saberi, Parya
- ORCID
- Venue
- AIDS Care
- Publisher
- Informa UK Limited
- Published
- 2019-05-28
- Volume
- 32
- Issue
- 8
- Pages
- 931-939
- ISSN
- 0954-0121 (ISSN-L)
- 1360-0451
- PMC
- PMC6881543
- OpenAlex
- W2947470107
- Cited by
- 32
- References
- 40
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 5 · 2023: 5 · 2022: 5 · 2021: 6 · 2020: 4 · 2019: 1
- FWCI
- 3.06
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- AIDS Care (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- California HIV/AIDS Research Program (HD15-SF-060)
- National Institute of Mental Health (K23MH097649, K24DA037034)
- National Institute on Drug Abuse
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Keywords
- youth living with HIV, antiretroviral therapy adherence, mental health services, substance use services, videoconferencing, depression, trauma, adverse childhood experiences, cannabis use, stimulant use, barriers to mental health care, HIV treatment engagement, digital health
- MeSH terms
- Adolescent, Adult, Mental Disorders, Child, Female, Humans, Male, Mental Health, Mental Health Services, San Francisco, HIV Infections, Telemedicine, Anti-HIV Agents, Substance-Related Disorders, Antiretroviral Therapy, Highly Active, Anti-Retroviral Agents, Medication Adherence, Young Adult
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