We sat down with Dr. Lisa Hightow-Weidman, Principal Investigator of the Behavior and Technology Lab at UNC School of Medicine, to discuss the importance of using technology to communicate with youth who are at risk for or are living with HIV.
Q: You have worked extensively at the intersection of technology and public health. What’s the role of social media in technology-based interventions?
A: With the rise of social media, there is an avenue to reach young people and adolescents with messaging about HIV prevention and engage them in public health information that isn’t necessarily research-related. It’s an avenue that’s comfortable for a lot of people. It’s a space that people go to communicate with others and share their feelings about the world. When we think about HIV and other sexually transmitted infections and sexual health, social media represents a place to meet folks where they are comfortable and to engage them in new and creative ways.
Q: What do you see on the horizon for mobile health? What new developments can we expect? How is it being used, and how are you currently using it in your work?
A: Mobile health (mHealth) has been expanding for the last ten years, which allows for a lot of advancements because smartphones have features that can make interventions exciting. You may not always be at a desktop, but everyone has a phone, and that cuts across race, gender, sexual identity, income, and even geography. Designing and thinking about mHealth interventions allows us to connect with people in a more personal and private manner. If you look at any discipline, such as diabetes, exercise, cardiovascular disease, you will see more mHealth-type interventions. We want to make interventions that are more engaging for youth, and that can be measured in terms of their efficacy across populations.
With our most recent grant from the National Institutes of Health (NIH), we partnered with Emory University to develop The Center for Innovative Technology (iTECH), which uses technology to engage adolescents, and young adults across the entire HIV prevention and care continuum. One project is P3, an app meant to increase PrEP adherence, which stands for Prepared, Protected and EmPowered. P3 is novel in that it’s not just a typical adherence app that sends you reminders to take your meds. It also has features for the users to engage with each other socially and includes daily quests, tailored medication strategies and knowledge-based interactive activities.
Q: As a medical practitioner that works directly with youth, what would you recommend to other practitioners to improve the doctor-patient relationship across the HIV continuum?
A: I’ve been taking care of youth for more than 20 years now. I think trying to promote mutual respect ensure that there are open lines of communication is critical. I also try to always remember that despite all my training and experience with HIV care, I will never be a young, Black, gay man with HIV. Recognizing that and being honest with my patients about what my values are as a provider makes me a better provider. My goal is to try and help patients lead better lives, and to ensure that I can do everything in my power to impact things in a beneficial way that are impacting their physical, mental, emotional, spiritual, and social health. Whatever part that I can play in helping them achieve a better life makes me a better provider. As long as patients feel empowered to find a provider that works for them, I think that we can really improve their engagement and care, which at the end of the day is what’s important.
Q: You were honorably discharged from the Air Force when you opened up about your own sexuality. How has that changed how you approach your work, especially for youth that are still struggling with stigma and discrimination?
A: It was really frightening that there was an institution that could have ultimate power over the rest of my life simply because I didn’t identify as straight. That certainly impacted the career I’ve chosen and my work with HIV. I knew from medical school that I wanted to go into HIV, not just because of my interest in the virus as a virus, but also how the virus impacted people and communities. I wanted to understand how the stigma related to the virus can impact the health of an individual and cause individuals not to get tested, treated, and not receive any of the support that they need.
The patients that I’ve taken care of have impacted me more than anything and influence the way that I treat the new patients of tomorrow. Despite the fact that most of my time is spent doing research, my clinic and my practice are really important to me because it keeps me grounded. As we think about the research protocols and what we’re asking youth to do and what we think they want, it’s helpful for me to reflect upon the person that was sitting in my clinic the day before to ensure that the interventions are meeting these youth where they are, not just serving the needs of “the research.”
Q: With National Youth HIV/AIDS Awareness Day around the corner on April 10, how do you recognize it?
A: Awareness days are useful to have a day to bring attention to the issue – but it’s only a day. We have to do better at making youth sexual health, and youth health in general, a priority every day.