Housed at Community AIDS Network/Akron Pride Initiative (CANAPI) and generously funded by the Ohio Department of Health (ODH) this quality innovation program aims to design, implement and evaluate a mobile application to improve health outcomes of Ohioans living with HIV/AIDS and reduce the transmission of HIV in Summit and Portage Counties.  The purpose of the mobile application is to reduce barriers in access to existing community resources that impact upstream social determinants of health such as inequities in employment, housing, food insecurities, healthcare and supportive services that encourage engagement with the HIV/AIDS Continuum of HIV Care: Category D, viral suppression.

The target population for the program will include people living with HIV/AIDS (PLWHA) who are not virally suppressed and are 18-24 years of age, Black/African American MSM, Transgender-Identified, Black/African American and Latino Women, and/or have a mental health/substance use diagnosis.

This program is estimated to impact many of the 1,073 reported HIV positive individuals living in Summit and Portage Counties reported by the Ohio Department of Health (ODH) in 2017. The ODH statistics reported in 2017 indicate that at least 27% of the 1,073 reported HIV positive individuals living in Summit County fall into one of the target population demographics listed above (Ohio Department of Health, 2018). Health disparities pattern national trends as prominent in Summit and Portage Counties.  HIV rates in particular disproportionately affect the minority populations this mHealth program is designed to target.  In a location where the African American population accounts for only 7.9% of the total population, 353 of the total reported HIV individuals (1073) are Black/African American men who have sex with men (MSM) or Black women.  This outlines the increased health risk of HIV among minority populations.

The objectives of this program will be achieved through individualized coordination of standardized services which support progression to viral suppression through new and existing collaborations CANAPI has and will established among public, private and not-for-profit agencies in Summit and Portage Counties.  Building and managing a single multi site database to collect relevant health information about individuals within the target population seeking and receiving HIV/AIDS care will allow the program a unique opportunity to capture a snapshot of population health demographic for HIV/AIDS surveillance that is currently lacking.

This mobile health technology will empower participants of this program to coordinate their own care and track their progress toward viral suppression through a single point of access to existing community resources.  Collectively, published scientific literature strongly suggests the application of mobile technology as a useful tool for public health practitioners to overcome barriers in access and efficiency in connecting disadvantaged and clients living in rural populations with existing community resources.

The World Health Organization (WHO) has developed an initiative, He Mobile (MHBM) to promote the use of mobile technology to achieve health outcomes.  The MHBM initiative develops handbooks that provide guidance for implementing mobile technology based program that share health information and supportive services available for the general population which support HRSA Approved Service Category: Health Education/Risk Reduction.  The MHBM initiative has developed handbooks that address chronic illnesses and health behaviors such as mTobaccoCessation, mDiabetes, mCervicalCancer, mBreatheFreely, and mAgeing, however none address people living with HIV/AIDS (PLWHA) (World Health Organization, 2018).

Despite certain limitations, growing use and access to mobile application technology helps extend the reach of public health programming to greater and rural populations, breaking down barriers that create inequities in the distribution of HIV/AIDS treatment resources.  Embracing mobile applications and internet based technologies can increase HIV testing, help prevent new HIV/AIDS infections, and connect those infected with HIV/AIDS to resources in the Summit and Portage Counties.  We anticipate, upon evaluation, that this program will become an exemplar program which can be replicated in other similar communities in Ohio and across the country.

The mobile application is available for download in both the Google Play and Apply Store:
https://play.google.com/store/apps/details?id=org.canapi.ican.android
https://apps.apple.com/us/app/ican-canapi/id1484291856