Language

English

Publication Date

10-10-2025

Journal

JMIR Research Protocols

DOI

10.2196/78006

PMID

41072013

PMCID

PMC12552824

PubMedCentral® Posted Date

10-10-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Youth who are experiencing homelessness face a higher risk of HIV infection compared to their housed peers, and suicide and overdose remain the leading causes of death among homeless youth. Just-in-Time Adaptive Interventions (JITAIs) are gaining momentum for HIV prevention and substance use research. Yet, most interventions for homeless youth have not addressed modifiable real-time factors.

Objective: This paper describes the development and implementation of a randomized attention-controlled trial to assess the efficacy of motivating youth to reduce infections, disconnections, and emotional dysregulation (MY-RIDE), a JITAI to improve HIV prevention and substance use in homeless youth.

Methods: This study will enroll 320 homeless youth aged 18-25 years. The intervention was co-designed with homeless youth using the Information-Motivation-Behavioral Skills Model and consists of an individual nurse-led session about HIV prevention and 3 months of a JITAI with personalized messaging delivered by phone in real time in response to one's current level of risk. Participants also had access to an on-demand nurse helpline through the app.

Results: Institutional review board approval was obtained in the summer of 2024. Recruitment began in the fall of 2024 at shelters, drop-in centers, and other organizations that serve homeless youth. Participants complete a baseline survey and HIV/sexually transmitted infection (STI) testing and are provided with a smartphone with the intervention app. Follow-up surveys and HIV/STI testing are conducted at immediate, 3-, 6-, and 12-month time points post intervention to assess uptake of HIV prevention strategies and substance use reduction. A total of 192 are enrolled to date.

Conclusions: The results of this study will determine whether MY-RIDE increases HIV prevention strategies and decreases substance use when compared to homeless youth in the attention control group. We will also evaluate if MY-RIDE impacts protective factors such as willingness to take pre-exposure prophylaxis medication and use of mental health and substance use services, and antecedents of risk such as stress, substance use urge, and substance use.

Keywords

Humans, HIV Infections, Adolescent, Homeless Youth, Young Adult, Substance-Related Disorders, Female, Male, Adult, Randomized Controlled Trials as Topic, Motivation, youth, homelessness, HIV, prevention, just-in-time adaptive interventions, mHealth, ecological momentary assessments, drug use, intervention, risk, mobile phone, mobile health

Comments

Trial registration: Clinicaltrials.gov NCT06074354; https://clinicaltrials.gov/study/NCT06074354.

International registered report identifier (irrid): DERR1-10.2196/78006.

Published Open-Access

yes

Download

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.