Evidence shows that patients with HIV who achieve and maintain a suppressed viral load are able to maintain their overall health and are unlikely to transmit HIV. Thus, simple, practical interventions to help achieve HIV viral suppression that are easy and inexpensive to administer in clinical settings are needed. For a study published in AIDS Care, we evaluated whether a brief video containing HIV-related health messages targeted to all patients in the waiting room improved treatment initiation, medication adherence, and retention in care, as well as whether assessing time points where patients stopped watching and missed embedded health messages could be used to refine the video.
We evaluated the medical outcomes of the “Taking Care of Me” video in a quasi-experimental trial in two HIV clinics in the southern US in 2016. Approximately 2,000 intervention patients were exposed over 10 months to a 29-minute video depicting persons overcoming barriers to starting treatment, taking medication as prescribed, and keeping medical appointments. Nearly 2,000 comparison patients had visited the clinics in the previous 10 months. Routinely collected electronic medical record (EMR) data were abstracted for patients seen during each study period. We used unobtrusive systematic observations for 8 hours at each of the clinics and a case management facility to assess patients’ engagement with the video and identify frequently unwatched scenes. We triangulated the observations with the EMR data.
The video intervention was shown to be effective in increasing the number of patients prescribed treatment (60.3% vs 70.7%) and improvement in viral suppression (56.7% vs 62.7%), although there were mixed results between sites on this measure. No significant change in rates of return visits (77.5% vs 78.8%) were observed. The effects appear independent of each facilities’ typical waiting times. Triangulation enabled us to identify specific scenes where low levels of engagement corresponded to lower-than-expected retention in care outcomes and edit these scenes to improve engagement and, potentially, intervention efficacy. This feasible, easy-to-deliver video intervention requires minimal resources to deliver and may be appropriate for adoption by facilities serving patients with HIV.