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Duke, UNC and Caktus Group Receive $1M NIMH Grant to Develop HIV App

January 20, 2015
Members of the Caktus Group trying the new HIV mhealth app

Researchers from Duke, UNC and Durham-based web application firm Caktus Group have been awarded a $1 million grant from the National Institute of Mental Health to refine and test Epic Allies, an innovative game-based smartphone app designed to help young HIV-positive men who have sex with men adhere to their HIV treatment plan.

Sara LeGrand, assistant research professor for global health at the Duke Global Health Institute (DGHI) and the Center for Health Policy and Inequalities Research, and Joseph Egger, research scholar at DGHI, represent Duke in this collaborative project. Lisa Hightow-Weidman, associate professor of medicine at UNC, serves as the lead UNC researcher.

Epic Allies Motivates Men to Take Medicine and Connect with Others

Geared toward young men who have sex with men ages 16-24, Epic Allies enables users to set reminders to take their medications and record when they’ve taken them. They’re also encouraged to track their mood and behaviors such as smoking, alcohol consumption, marijuana use and exercise. The act of documenting these behaviors can help raise users’ awareness of factors that may impact their medication adherence. The app awards virtual medals for use of these features.

But the features that will probably be most compelling and motivating to users, says LeGrand, are the social networking and games. Each day, users are paired with up to five anonymous “allies”—other young HIV-positive men who have sex with men who are also using the app—and users can send messages that encourage allies to improve their adherence or congratulate them for adherence successes. The games are somewhat related to adherence, but their primary function is entertainment and motivation; users can unlock games using the medals they receive for engaging with the other components of the app.

Epic Allies also offers resources and information designed to help users increase their knowledge of HIV and the importance of medication adherence—and by answering related quiz questions, they earn access to new games.

Epic Allies Addresses a Critical Need 

Men who have sex with men (MSM) account for nearly two-thirds of all new HIV infections in the United States, and young MSM are the only risk group experiencing an increase in HIV incidence. And after diagnosis, many of these men do not enter medical care, get prescribed medication, or adhere to their medication regimens. Therefore, there’s a significant need for interventions that not only address these issues, but do so in a way that resonates with this population.

LeGrand notes that young HIV-positive MSM can be a difficult group to reach because they’re often stigmatized by their peers, family, and community. “This tool gives these young men new knowledge and skills in an engaging format and offers a way for them to connect with others like them,” she said. “And better yet, it meets them where they are—on their smartphones.”

Funding Will Cover App Development and Testing

The grant is from the National Institutes of Health’s Small Business Innovation Research (SBIR) program, which supports research and development collaboration between higher education institutions and small entrepreneurial businesses. 
 
The grant will fund the remaining development of the app and a randomized controlled trial to test its effectiveness with the target audience. Additional support from the Adolescent Medicine Trials Network (ATN) for HIV/AIDS will enable the team to test the app at the 14 ATN sites across the United States.

Epic Allies Taps into Growing mHealth Field

By leveraging the powerful potential and scalability of interventions delivered via mobile phones, the research team hopes that Epic Allies will effectively address two critical challenges: reaching the often marginalized population of young HIV-positive MSM and getting patients to follow their medication regimen. 

Learn more about Sara LeGrand’s work with DGHI.

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