New mHealth Intervention Aims to Curb Smoking Among Black HIV Patients

January 09, 2023 - Following a $1.3 million grant from the National Institute of Drug Abuse, Lorra Garey, a researcher from the University of Houston RESTORE Lab, plans to lead a research project to assess the impact of an mHealth application to mitigate smoking among Black people with HIV.

HIV, a virus that attacks the body's immune system, affects a large portion of the worldwide population. According to the World Health Organization, it has led to 40 million deaths globally. In addition, the US Department of Veterans Affairs noted that about 20 percent of US citizens with HIV are not aware that they have it, according to the press release.

Further, Centers for Disease Control and Prevention (CDC) data shows that about 13 percent of Black Americans with HIV do not know they have the condition. As a result, the use of treatment leading to viral suppression among this population is low compared with their White and Hispanic peers.

It is also widely known that smoking status is a key factor in HIV disease management as it can have serious health consequences for those with the disease. It has also been noted that HIV patients are more likely to smoke.

“Chronic and stigmatized diseases, such as HIV, are associated with a lot of different life stressors. Within communities of color, these stressors are on top of daily life stressors experienced because of being a person of color, including microaggressions, racism and discrimination,” said Garey in a press release. “The combination of these things makes disease and stress management more challenging within these groups, which, in part, is likely to lead to substance use to cope.” 

To address this issue, Garey and a team of researchers are working to create a mobile app-based intervention for Black HIV patients who smoke. Named “A Fully Automated and Culturally Adapted Health Intervention for Smoking Cessation Among Black Smokers with HIV,” this effort received a $1.3 million Notice of Special Interest (NOSI) grant from the National Institute on Drug Abuse. This came as a supplemental award under an existing award for the University of Houston's HEALTH Center for Additions and Cancer Prevention led by Ezemenari Obasi, PhD.

For the research project, Garey and her team are recruiting 72 HIV-positive individuals. The smoking cessation app features real-time interventions and motivational messages to support HIV symptom management.

Further, Garey noted that materials available on the app are adapted from materials provided by the Mobile Anxiety Sensitivity Program for smoking (MASP) mobile smoking cessation intervention project.

“We are modifying materials (from the MASP app) to incorporate psychoeducation about HIV, being a smoker and how it affects mood, the risks of poor health outcomes and considering these complicated interconnected factors,” said Garey. “We’re also partnering with other people on this grant who have HIV expertise. We are drawing from their experience to make sure that this intervention is acceptable, empirically-supported and appropriate for our target population.”  

mHealth applications are increasingly being used in healthcare settings, but they require further study to assess their usefulness.

In July 2022, Stanford Medicine researchers determined that a smartphone app could help detect skin cancer among older patients.

Researchers found that older patients visited dermatology clinics less between 2019 and 2020. But during the same time, the number of skin cancer diagnoses among this population decreased by 23 percent.

Known as SkinIO, the app delivers photos of potentially cancerous lesions to dermatologists. It also highlights suspicious images, informing providers when further review is necessary.

In a trial, the app found that 63 percent of lesions needed further attention. But researchers noted that most were benign, and only three of the study participants had cancerous lesions. This led them to conclude that though the app was helpful, it may only be somewhat reliable.