Back to Journals » Patient Preference and Adherence » Volume 10

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

Authors Nachega JB, Skinner D, Jennings L, Magidson JF, Altice FL, Burke JG, Lester RT, Uthman OA, Knowlton AR, Cotton MF, Anderson JR, Theron GB

Received 6 November 2015

Accepted for publication 11 February 2016

Published 28 April 2016 Volume 2016:10 Pages 683—690

DOI https://doi.org/10.2147/PPA.S100002

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Jean B Nachega,1,2 Donald Skinner,3 Larissa Jennings,4 Jessica F Magidson,5 Frederick L Altice,6 Jessica G Burke,7 Richard T Lester,8 Olalekan A Uthman,9,10 Amy R Knowlton,11 Mark F Cotton,12 Jean R Anderson,13 Gerhard B Theron14

1Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA; 2Department of Medicine, Centre for Infectious Diseases, and ACTG Clinical Trial Unit (CTU)/Family Clinical Research Unit (FAMCRU), 3Research on Health and Society, Department of Interdisciplinary Health Studies, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; 4Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 5Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 6Division of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, CT, 7Department of Behavioral and Community Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA; 8Department of Medicine, Division of Infectious Diseases, University of British Columbia, Vancouver, BC, Canada; 9Warwick Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK; 10Centre for Evidence-Based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; 11Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 12Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; 13Department of Obstetrics and Gynecology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; 14Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

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.

Keywords:
HIV, AIDS, pregnancy, short messaging system, social support

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Other articles by this author:

Readers of this article also read:

Using the Dynamic Appraisal of Situational Aggression with mental health inpatients: a feasibility study

Lantta T, Kontio R, Daffern M, Adams CE, Välimäki M

Patient Preference and Adherence 2016, 10:691-701

Published Date: 28 April 2016

Emerging and future therapies for hemophilia

Carr ME, Tortella BJ

Journal of Blood Medicine 2015, 6:245-255

Published Date: 3 September 2015

Green synthesis of water-soluble nontoxic polymeric nanocomposites containing silver nanoparticles

Prozorova GF, Pozdnyakov AS, Kuznetsova NP, Korzhova SA, Emel’yanov AI, Ermakova TG, Fadeeva TV, Sosedova LM

International Journal of Nanomedicine 2014, 9:1883-1889

Published Date: 16 April 2014

Methacrylic-based nanogels for the pH-sensitive delivery of 5-Fluorouracil in the colon

Ashwanikumar N, Kumar NA, Nair SA, Kumar GS

International Journal of Nanomedicine 2012, 7:5769-5779

Published Date: 15 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010