Grant: Project Grant

In Canada where HIV medications are freely available to all in need, the biggest barrier to preventing new HIV infections and keeping HIV-positive persons well is adherence. WelTel is a text messaging program sending weekly text messages to patients stating "How are you?" A nurse responds and helps solve patient "problems" on a daily basis. Previous studies show that WelTel improves health and adherence to HIV medications. However, for many people who would benefit from the program, a cell phone must be provided (if the patient does not have one). This can be expensive, and so determining who would benefit most from the program would aid in personalizing care, and using scarce resources in the best way possible. Data shows that personality traits and sense of purpose (disposition) effect the health of HIV-positive persons. Likewise, disposition may impact the effectiveness of WelTel, and WelTel (an intervention empowering participants and builds links with their care providers) may have an affect on disposition over time. Measures of disposition are simple and rapid, can be incorporated into routine care with relative ease; and could thus be used to provide personalized patient care. We will enroll 300 HIV-positive persons in a study where they will receive a weekly text message stating "How are you?" for 18 months. "Problems" will be triaged by a nurse. We will examine personal disposition at baseline then at intervals throughout the study in order to see if disposition predicts who will benefit most from WelTel. We will also collect data on how well patients are doing at study beginning, then at intervals throughout. These data will include response rate to text messages, HIV viral load, medication adherence, engagement in care, and resilience. We will use this data to predict who will benefit most from WelTel, and to see if personality traits and sense of life purpose change over time in the setting of a program that provides increased links with care provider