Dr. Jamila K. Stockman from the University of California, San Diego and Dr. Keith J. Horvath from the San Diego State University Research Foundation will develop and pilot test a culturally tailored, trauma-informed smartphone app, called LinkPositively, for Black WLHA affected by interpersonal violence. Core components of LinkPositively include: a) Virtual Peer Navigation that includes phone and text check-ins and 4 weekly one-on-one video sessions to build skills to cope with barriers and navigate care; b) Social Networking platform to receive peer support; c) Educational and Self-care database with healthy living and self-care tips; d) GPS-enabled Resource Locator for HIV care and ancillary support service agencies; and e) ART self-monitoring and reminder system. Guided by the Theory of Triadic Influences and Syndemic Theory, the study will be conducted in two phases with corresponding aims. In Phase 1, four focus groups with Black WLHA with experiences of interpersonal violence, one focus group with peer navigators, and 4-6 key informant interviews with providers will be conducted to determine which app features, content, and functions are most likely to support downloading, initiating use, and sustaining engagement over time. Aim 1 will culminate in usability testing by Black WLHA affected by interpersonal violence (n=8), to finalize intervention components and procedures. In Phase 2 , we will pilot test LinkPositively to assess feasibility and acceptability and determine preliminary effects of the intervention on HIV care outcomes (i.e., retention in care, ART adherence, viral suppression) and mechanism of change variables (i.e., social support, self-efficacy). Through a randomized control trial (RCT), participants will be randomly assigned to either the intervention arm or control arm, with follow-up at 3- and 6- months. This study will benefit the advancement of HIV prevention science by harnessing technology to promote engagement in HIV care, while improving social support through peers and social networking–all under the auspices of being trauma-informed for Black WLHA with experiences of interpersonal violence.

The specific aims of this study are: Aim 1: Develop the LinkPositively mobile intervention through focus groups (FGs) with Black WLHA affected by interpersonal violence, peer navigators, and service providers, and refine iterations through input from the San Diego CFAR Disparities Core CAB. Aim 2: Conduct a pilot randomized controlled trial to assess the feasibility, acceptability and preliminary impact of the LinkPositively intervention for Black WLHA affected by interpersonal violence, in preparation for a large-scale R01.