Outcomes of a Pilot Mobile App Just-in-Time-Adaptive-Intervention Supporting Coping Skills in Trauma Affected People with HIV.

People with HIV (PWH) experience trauma and mental health burdens at higher rates than seronegative individuals. Psychosocial interventions have shown promise for improving mental health and coping among PWH, but relatively few trauma-informed, coping-focused mobile health (mHealth) interventions exist. This pilot study evaluates the preliminary outcomes of NOLA Gem, a just-in-time adaptive intervention (JITAI)-based mHealth app designed to support real-time coping among people living with HIV (PWH) in the New Orleans area. Participants were assigned to either a control or intervention group; the intervention group received access to the NOLA Gem app, which delivered psychoeducation modules and just-in-time skill suggestions based on daily diary responses over a three-week period. Both groups completed brief daily diary surveys over the 3-week period to assess stress, emotion regulation, and coping outcomes. Analyses demonstrated positive changes in treatment compared to control, particularly in the final week. From week 1 to week 3, participants in the treatment group experienced significant reductions in maladaptive coping, rumination, and PTSD symptoms compared to the control group, along with increased feelings of control over stress at both timepoints. These effects were especially pronounced among high completers, who demonstrated greater improvements in maladaptive coping, rumination, and stress control compared to both low completers and controls. High completers also showed significant decreases in overall stress and self-reported alcohol use. These preliminary findings suggest that NOLA Gem is a promising intervention for improving coping and reducing trauma-related symptoms among PWH, particularly for those who actively engage with the app.Trial Registration: ClinicalTrials.gov NCT05784714; https//clinicaltrials.gov/ct2/show/NCT05784714.