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Acceptability and feasibility of mHealth and community-based directly observed antiretroviral therapy to prevent mother-to-child HIV transmission in South African pregnant women under Option B+ : an exploratory study
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Nachega, Jean B., Skinner, Donald, Jennings, Larissa, Magidson, Jessica F., Altice, Frederick, Burke, Jessica G., Lester, Richard T., Uthman, Olalekan A., Knowlton, Amy, Cotton, Mark F., Anderson, Jean and Theron, Gerhard (2016) Acceptability and feasibility of mHealth and community-based directly observed antiretroviral therapy to prevent mother-to-child HIV transmission in South African pregnant women under Option B+ : an exploratory study. Patient Preference and Adherence, 2016 (10). pp. 683-690. doi:10.2147/PPA.S100002 ISSN 1177-889X.
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Official URL: http://dx.doi.org/10.2147/PPA.S100002
Abstract
Objective: To examine the acceptability and feasibility of mobile health (mHealth)/short message service (SMS) and community-based directly observed antiretroviral therapy (cDOT) as interventions to improve antiretroviral therapy (ART) adherence for preventing mother-to-child human immunodeficiency virus (HIV) transmission (PMTCT).
Design and methods: A mixed-method approach was used. Two qualitative focus group discussions with HIV-infected pregnant women (n=20) examined the acceptability and feasibility of two ART adherence interventions for PMTCT: 1) SMS text messaging and 2) patient-nominated cDOT supporters. Additionally, 109 HIV-infected, pregnant South African women (18–30 years old) receiving PMTCT services under single-tablet antiretroviral therapy regimen during pregnancy and breastfeeding and continuing for life (“Option B+”) were interviewed about mobile phone access, SMS use, and potential treatment supporters.
Setting: A community primary care clinic in Cape Town, South Africa.
Participants: HIV-infected pregnant women.
Main outcomes: Acceptability and feasibility of mHealth and cDOT interventions.
Results: Among the 109 women interviewed, individual mobile phone access and SMS use were high (>90%), and 88.1% of women were interested in receiving SMS ART adherence support messages such as reminders, motivation, and medication updates. Nearly all women (95%) identified at least one person close to them to whom they had disclosed their HIV status and would nominate as a cDOT supporter. Focus group discussions revealed that cDOT supporters and adherence text messages were valued, but some concerns regarding supporter time availability and risk of unintended HIV status disclosure were expressed.
Conclusion: mHealth and/or cDOT supporter as interventions to improve ART adherence are feasible in this setting. However, safe HIV status disclosure to treatment supporters and confidentiality of text messaging content about HIV and ART were deemed crucial.
Item Type: | Journal Article | ||||
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Subjects: | R Medicine > RA Public aspects of medicine | ||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Antiretroviral agents -- South Africa, HIV infections -- Prevention -- South Africa, Wireless communication systems in medical care -- South Africa | ||||
Journal or Publication Title: | Patient Preference and Adherence | ||||
Publisher: | Dove Press | ||||
ISSN: | 1177-889X | ||||
Official Date: | 28 April 2016 | ||||
Dates: |
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Volume: | 2016 | ||||
Number: | 10 | ||||
Page Range: | pp. 683-690 | ||||
DOI: | 10.2147/PPA.S100002 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access | ||||
Date of first compliant deposit: | 1 June 2016 | ||||
Date of first compliant Open Access: | 1 June 2016 | ||||
Funder: | National Institutes of Health (U.S.) (NIH), National Institutes of Allergy and Infectious Disease (U.S.), AIDS Clinical Trial Group, Stellenbosch University Clinical Trial Unit, US President Emergency Plan for AIDS Relief (PEPFAR), European Developing Countries Clinical Trial Partnership, Wellcome Trust (London, England), National Institute on Drug Abuse, National Institutes of Mental Health (U.S.) (NIMH), Michael Smith Foundation for Health Research, Grand Challenges Canada, Forskningsrådet för arbetsliv och socialvetenskap (Sweden) (FAS) | ||||
Grant number: | 2UM1AI069521-08 (ACTG), T84HA21652-01-00 (PEPFAR), TA-08-40200-021 (EDCCTP), WT087537MA (WT), R01-DA10186 (NIDA), R01 DA13805 (NIDA), R01 DA017072 (NIDA), K24 DA017072 (NIDA), R01-MH09755 (NIH), 2012-0064 (FAS), T32MH093310 (NIMH) |
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