scholarly journals Feasibility of SMS to remind pregnant and breastfeeding women living with HIV to take antiretroviral treatment in Kilimanjaro region, Tanzania: a pilot study

2020 ◽  
Vol 4 (2) ◽  
pp. 140-148
Author(s):  
Kennedy M Ngowi ◽  
Eusebious Maro ◽  
Rob E Aarnoutse ◽  
Blandina T Mmbaga ◽  
Mirjam A. G Sprangers ◽  
...  
Keyword(s):  
Pilot Study ◽  
Antiretroviral Treatment ◽  
Network Failure ◽  
Women Living With Hiv ◽  
Resource Limited ◽  
Sms Reminders ◽  
Kilimanjaro Christian Medical Centre ◽  
Living With Hiv ◽  
Lost To Follow Up ◽  
Privacy Issues

Background: Pregnant and breastfeeding Women Living with HIV (WLHIV) often have difficulties in reaching adequate levels of adherence (>95%) to Antiretroviral treatment. “Forgetting” is the most commonly mentioned reason. Sending reminders via SMS is expected to improve adherence. We conducted a pilot study to investigate acceptability, user experience and technical feasibility of sending reminder-SMS to WLHIV. Methods: This was a 6-months observational pilot-study among WLHIV attending antenatal and postnatal care at Kilimanjaro Christian Medical Centre in Moshi, Tanzania. Women received a reminder-SMS 30 minutes before usual time of intake. One hour later, they received an SMS asking whether they took medication to which they could reply with ‘Yes’ or ‘No’. Messages were sent 3 times a week on randomly chosen days to prevent reliance on daily messages. We calculated the percentage of number of SMS delivered, failed to be delivered, and replied to. We analysed feedback from exit-interviews about experience with the SMS-reminders. Results: 25 women were enrolled (age 18-45), 2 were lost to follow up. 5,054 messages were sent of which 53 failed to be delivered (1%). 1,880 SMS were sent with a question if medication was taken; 1,012 (54%) messages were replied to, of which 1,003 (99%) were replied with ‘YES’ and closely to ‘YES’, and a total of 9 (1%) with ‘NO’ and ‘closely to NO’. 868 messages (46%) were not responded to due to either dropout, change of phone number, loss of phone or network failure. Results from 18 interviews showed that 16 (89%) women were satisfied with SMS reminders. 2 (11%) were concerned about unwanted disclosure because of the content ‘don’t forget to take medication’ and one reported other privacy issues (6%). 3 (17%) women experienced stigma. Conclusion: 99%of SMS being delivered indicates that SMS reminders in this resource-limited setting are technically feasible. However, concerns regarding privacy were noted, specifically the risk of unwanted disclosure and the experience of stigma. Participants indicated that being made aware of their adherence, motivated them to adhere better. However, personalised and more neutral content of the SMS might be a way to improving the intervention.

scholarly journals PO 8476 USER EXPERIENCE OF SMS REMINDERS TO TAKE MEDICATION AMONG PREGNANT AND BREASTFEEDING WOMEN LIVING WITH HIV IN KILIMANJARO, TANZANIA

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A43.2-A43
Author(s):  
Kennedy M Ngowi ◽  
Eusibious Maro ◽  
Pythia T Nieuwkerk ◽  
Rob E Aarnoutse ◽  
Blandina T Mmbaga ◽  
...  
Keyword(s):  
Clinical Trial Design ◽  
Short Message ◽  
Adult Age ◽  
Women Living With Hiv ◽  
System A ◽  
Message Service ◽  
Sms Reminders ◽  
Living With Hiv ◽  
Lost To Follow Up ◽  
Privacy Issues

BackgroundPregnant women living with HIV have difficulties in reaching adequate levels of treatment adherence. One way to intervene is sending reminder cues using short message service (SMS) texts. We conducted a pilot study on the use of SMS among pregnant and breastfeeding women living with HIV in Kilimanjaro, Tanzania. One objective was to investigate user experiences of SMS reminders.MethodsWe enrolled adult (age 18–45) pregnant or breastfeeding women living with HIV from Kilimanjaro region, Tanzania. Women received a reminder SMS 30 min before usual time of intake. One hour after usual time of intake, they received an SMS asking whether medication was taken. SMSes were sent less-than-daily and randomly distributed over the week. During consultation we listened to their feedback on the system. After six-months, we interviewed women using a semi-structured exit interview.ResultsTwenty-five women were enrolled. Two women were lost to follow-up. We received feedback from 18 women. Sixteen (89%) said they were content about the SMS reminding. One said she had problems with privacy issues (6%), but 5 specifically mentioned no privacy issues (28%). Preliminary results of 18 exit interviews show that 16 women (89%) had a good experience with the SMS. Fourteen women (78%) found the content of SMS good; 2 women (11%) said it was not good at all due to risk of unwanted disclosure. Three women (17%) experienced stigma. Eleven women (61%) told they were always able to reply to the SMS and 16 (89%) believed it really improves adherence.ConclusionWe believe most women were satisfied with the SMS system. A few women had trouble with risks or fear of unwanted disclosure. One way to solve that, may be to send more neutral language messages. The results can be used for clinical trial design to investigate the effect on adherence.

Implementing the Jadelle implant for women living with HIV in a resource-limited setting

AIDS ◽  
2014 ◽  
Vol 28 (5) ◽  
pp. 791-793 ◽  
Author(s):  
Sarah H. Perry ◽  
Padma Swamy ◽  
Geoffrey A. Preidis ◽  
Anne Mwanyumba ◽  
Nozipho Motsa ◽  
...  
Keyword(s):  
Resource Limited Setting ◽  
Women Living With Hiv ◽  
Resource Limited ◽  
Living With Hiv ◽  
Limited Setting

scholarly journals Outcomes of retained and disengaged pregnant women living with HIV in Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251413
Author(s):  
Agnes N. Kiragga ◽  
Ellon Twinomuhwezi ◽  
Grace Banturaki ◽  
Marion Achieng ◽  
Juliet Nampala ◽  
...  
Keyword(s):  
Post Partum ◽  
Urban Environments ◽  
Hiv Viral Load ◽  
Viral Loads ◽  
Women Living With Hiv ◽  
Resource Limited ◽  
Increased Risk ◽  
Exposed Infant ◽  
Public Clinics ◽  
Living With Hiv

Introduction Loss-to-follow-up among women living with HIV (WLWHIV) may lead to unfavorable outcomes for both mother and exposed infant. This study traced WLWHIV disengaged from care and their infants and compared their outcomes with those retained in care. Methods The study included WLWHIV who initiated ART during pregnancy at six public clinics in Uganda. A woman was defined as disengaged (DW) if she had not attended her 6-week post-partum visit by 10 weeks after her estimated date of delivery. DW were matched with retained women (RW) by age and duration on ART. Nurse counselors traced all selected DW via telephone and community visits to assess vital status, infant HIV sero-status and maternal HIV viral load through blood draws. Results Between July 2017 and July 2018, 734 women (359 DW and 375 RW) were identified for the study. Tracing was attempted on 349 DW and 160 (44.6%) were successfully located and enrolled in the study. They were matched with 162 RW. Among DW, 52 (32.5%) transferred to another health facility. Very few DW, 39.0% were HIV virally suppressed (<1000 copies/ml) compared to RW 89.5%, P<0.001). Among 138 babies born to DW, 4.3% tested positive for HIV compared to 1.4% among babies born to RW (P = 0.163). Conclusion Pregnant and breastfeeding WLWHIV who disengage from care are difficult to find in urban environments. Many have detectable viral loads, leading to the potential for an increased risk of MTCT. Efforts to reduce disengagement from care are critical for the successful elimination of MTCT in resource-limited settings.

Utility and acceptability of text messages for PMTCT: a qualitative assessment of user experiences (Preprint)

2021 ◽  
Author(s):  
Melinda Brown ◽  
May Maloba ◽  
Catherine Wexler ◽  
Natabhona Mabachi ◽  
Sharon Koech ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Pilot Study ◽  
Clinical Care ◽  
Text Messages ◽  
Hiv Care ◽  
Qualitative Assessment ◽  
Women Living With Hiv ◽  
Pregnancy And Postpartum ◽  
Living With Hiv ◽  
The Impact

BACKGROUND Evidence that text messages can support patient adherence to HIV care is growing. We conducted a pilot study of the HIV Infant Tracking System (HITSystem 2.0), an intervention that includes SMS to patients to support maternal medication adherence, appointment attendance, and hospital-based deliveries during the antenatal period. OBJECTIVE The objective of this study was to qualitatively assess women’s experiences receiving SMS to understand message utility and acceptability with the goal of refining and strengthening the intervention. METHODS As part of an intervention development pilot study, we conducted semi-structured interviews with 33 women living with HIV who received SMS through the HITSystem 2.0 throughout their pregnancy and postpartum period. Interview questions assessed women’s feedback of the SMS, the impact of the SMS on their PMTCT care, and suggestions for improvement. RESULTS Participants described how SMS reinforced existing strategies for medication adherence and served as cues to action for antenatal appointments and hospital-based deliveries. SMS also provided encouragement and enhanced their sense of engagement with their clinical care team. Given the neutral content of the messages, most women reported no concerns about message confidentiality. Recommendations to enhance utility included greater customizability (timing and frequency of messages) and a few women suggested more comprehensive counseling regarding the SMS content to anticipate at the time of enrollment. CONCLUSIONS SMS content was deemed useful and acceptable by pregnant and postpartum women living with HIV and engaged in PMTCT services. Participant recommendations to increase message customization options have been adopted to enhance the intervention. CLINICALTRIAL Trial registration: clinicaltrials.gov, NCT02726607. Registered 01 April 2016. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT02726607

scholarly journals The Impact of Cumulative Depression Along the HIV Care Continuum in Women Living With HIV During the Era of Universal Antiretroviral Treatment

2019 ◽  
Vol 82 (3) ◽  
pp. 225-233 ◽  
Author(s):  
Jon C. Mills ◽  
Brian W. Pence ◽  
Andrew Edmonds ◽  
Adebola Adedimeji ◽  
Rebecca M. Schwartz ◽  
...  
Keyword(s):  
Antiretroviral Treatment ◽  
Hiv Care ◽  
Hiv Care Continuum ◽  
Care Continuum ◽  
Women Living With Hiv ◽  
Living With Hiv ◽  
The Impact

scholarly journals Antiretroviral therapy self-management: Pilot study of an electronic medication event monitoring system among African-American women living with HIV in rural Florida (Preprint)

2019 ◽  
Author(s):  
Robert Lucero ◽  
Renessa Williams ◽  
Tanisia Esalomi ◽  
Paula Alexander-Delpech ◽  
Christa Cook ◽  
...  
Keyword(s):  
African American ◽  
Antiretroviral Therapy ◽  
Pilot Study ◽  
African American Women ◽  
Art Adherence ◽  
Event Monitoring ◽  
Women Living With Hiv ◽  
The Us ◽  
Rural Florida ◽  
Living With Hiv

BACKGROUND The human immunodeficiency virus (HIV) remains a significant health issue in the United States and disproportionately affects African Americans. African-American women living with HIV (AAWH) experience a particularly high number of barriers when attempting to manage their HIV care, including antiretroviral therapy (ART) adherence. To enable the development and assessment of effective interventions that address these barriers to support ART adherence, there is a critical need to understand more fully the use of objective measures of ART adherence among AAWH, including electronic medication dispensers for real-time surveillance. OBJECTIVE To evaluate the use of the Wisepill Medication Event Monitoring System (MEMS), and compare objective and subjective measures of ART adherence. METHODS We conducted a 30-day exploratory sequential mixed-methods pilot study of the MEMS among a convenience sample of community-dwelling AAWH (n=14) in rural Florida. AAWH were trained on the use of the MEMS to determine the feasibility of collecting, capturing, and manipulating the MEMS data for an objective measure of ART adherence. Self-report sociodemographic information, including a measure of antiretroviral therapy (ART) adherence, was also collected from AAWH. RESULTS We found that a majority of participants were successful at using the electronic MEMS. Daily use of the MEMS tended to be outside of the usual time participants took their medication. Three 30-day medication event patterns were found that characterized ART adherence, specifically uniformed and ununiformed medication adherence and ununiformed medication non-adherence. There were relatively few MEMS disruption among study participants. Overall, adjusted daily ART adherence was 81.08% and subjective ART adherence was 77.78%. CONCLUSIONS This pilot study on the use and evaluation of the Wisepill MEMS among AAWH in rural Florida is the first known in the US. The findings of this study are encouraging because ten out of twelve participants consistently used the MEMS, had relatively few MEMS, and objective adjusted daily and overall subjective ART adherence were very similar. Based findings from this study, we think researchers can be confident in using the Wisepill MEMS in future studies of AAWH and PLWH in the US after considering our practical suggestions. The following practical considerations are suggested when considering measuring objective medication adherence: (1) before using a MEMS be familiar with the targeted populations’ characteristics; (2) choose a MEMS that aligns with the participants’ day-to-day activities; (3) ensure the MEMS’ features and resulting data support the research goals; (4) assess the match between user’s ability, wireless features of the MEMS, and the geographic location of participants; and (5) considering the cost of MEMS and the research budget.

scholarly journals Intensification of antiretroviral treatment with raltegravir for pregnant women living with HIV at high risk of vertical transmission

2018 ◽  
Vol 4 (2) ◽  
pp. 61-65 ◽  
Author(s):  
Thanyawee Puthanakit ◽  
Nattawan Thepnarong ◽  
Surasith Chaithongwongwatthana ◽  
Suvaporn Anugulruengkitt ◽  
Orawan Anunsittichai ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Antiretroviral Treatment ◽  
Women Living With Hiv ◽  
Living With Hiv
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