Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Multisite Randomized Trial of Battle Viro: A Mobile Gaming App to Improve ART Adherence for Youth
Brief Summary: Despite the need for consistent adherence to medical care, youth living with HIV have low rates of adherence to medications and treatment. There are few interventions to improve adherence to HIV medications and treatment for youth, and there is a great need for novel approaches that are engaging for this age group. The investigators developed an intervention that includes a mobile gaming app that is integrated with a 7-day electronic medication device and text messages. During gameplay, youth fight HIV in colorful organ systems. A small previous project found that the intervention helped youth who were newly starting medications for HIV by improving adherence and decreasing HIV virus in their bodies (viral load). This proposed project will test the intervention with larger number of youth (100) who are newly starting HIV treatment and medications in New England, Georgia, and in Mississippi. The investigators want to determine if adherence is improved and viral load is reduced in this larger sample.


Options:
A: Inclusion Criteria:

* Living with HIV
* English speaking
* Have started antiretroviral therapy (ART) in the last three months or restarted ART in the last three months after not taking ART for approximately six months
* Have access to a smartphone for the duration of the study
* Not involved with another HIV prevention or adherence related study
* Able to give consent/assent and not impaired by cognitive or medical limitations as per clinical assessment
* Detectable viral load

Exclusion Criteria:

* None
B: Inclusion Criteria:

* Have a diagnosis of HIV
* Report past 30 days adherence of 80% or less as measured using the Visual Analogue Scale (VAS), or have a viral load of over 400 copies/mL
* Be able to communicate and read in English or Spanish
* Live in the US
* Have a smartphone
* Be taking ART medications

Exclusion Criteria:

* Participation in any other mobile app study for PLWH, including text messaging studies
* Diagnosis of a clinical problem that would preclude someone from using a smartphone
C: Inclusion Criteria:

* Child presenting for pentavalent 1- vaccine
* Caregivers who owned a cellphone or had access to one
* Caregivers permanently residing in Korangi Town, Karachi

Exclusion Criteria:

* Child presenting for a vaccine other than pentavalent -1
* Caregivers not having access to a cell phone
* Caregivers residing outside of Korangi or planning to move from the catchment area
D: Inclusion Criteria:

* Pregnant women age 18 to 40 years
* Singleton birth (e.g. no twins or triplets)
* Prenatal intention to breastfeed
* Have a mobile phone capable of receiving SMS text messages and phone calls
* Know how to send a text message
* ≥4th grade literacy level

Exclusion Criteria:

* Non-fluent in English
* Known fetal anomaly
* Infant delivery \<37 weeks
* \>3 days in neonatal intensive care unit (NICU)
* Medical history: pre-pregnancy BMI \>50, history of thyroid disorders, failed one hour and three hour glucola test or if they ever needed oral hypoglycemic, hypertension (HTN) before/during pregnancy, postpartum hemorrhage
* Medically contraindicated for breastfeeding (provider's judgment)
* Women who will breastfeed but not from their own breast (e.g. buy breast milk on the Internet/milk bank)
* Women who are hesitant about answering a series of text messages regularly
* Women who are unable to be contacted by SMS text message or are unwilling to provide their contact number
* Women with neurologic, anatomic, or cognitive disorders that are unable to consent and/or answer text messages

Answer: A