SMS messaging to improve ART adherence: perspectives of pregnant HIV-infected women in Kenya on HIV-related message content
SMS messaging to improve ART adherence: perspectives of pregnant HIV-infected women in Kenya on HIV-related message content
复制标题
DOI：
10.1080/09540121.2017.1417971
复制
发表时间：
2018-01-01
影响因子：
1.7
通讯作者：
John-Stewart, Grace
中科院分区：
文献类型：
--
作者：
Ronen, Keshet;Unger, Jennifer A.;John-Stewart, Grace
越来越多的证据表明，包括短信服务（SMS）在内的移动医疗（mHealth）方法可以提高抗逆转录病毒治疗（ART）的依从性，但在艾滋病毒相关信息的传播方面缺乏共识。迄今为止，大多数干预措施提供的短信没有公开提及艾滋病毒或抗逆转录病毒药物，以避免状况泄露的风险。在一项正在进行的随机对照试验（RCT）的形成性工作中，我们对肯尼亚预防母婴传播（PMTCT）依从性的单向和双向教育短信进行了评估，我们对87名感染艾滋病毒的围产期妇女进行了10次焦点小组讨论（fgd），以确定艾滋病毒相关内容的可取性和首选术语。随机对照试验的SMS是根据FGD结果制定的。大约一半的FGD参与者支持接收包含明显与艾滋病毒相关术语的短信，例如艾滋病毒和药物，他们表示希望获得有关抗逆转录病毒治疗和预防母婴传播的详细教育信息。那些反对公开内容的人表达了对机密性的担忧。许多与会者认为，与艾滋病毒有关的内容的可接受性取决于接收者的披露状态和其他人是否可以访问她的手机。基于这些发现，为RCT开发了隐蔽和公开的短信，拥有手机或向任何可以访问其手机的人透露其艾滋病毒状况的参与者可以选择以下三种选项之一：(1)仅隐蔽短信，(2)仅公开短信回应参与者提出的艾滋病毒相关问题，(3)常规公开短信，由研究发起。在RCT的825名参与者中，94%的人有资格收到公开的短信。其中，66%的人选择接收常规的公开短信，10%的人选择接收参与者发起的公开短信。这些发现表明，当状态披露的风险较低时，人们可能对通过短信公开艾滋病毒相关信息感兴趣，并支持使用允许参与者选择艾滋病毒相关内容的消息传递策略，同时防止不希望的披露。
There is growing evidence that mobile health (mHealth) approaches including short messaging service (SMS) can improve antiretroviral therapy (ART) adherence, but consensus is lacking regarding communication of HIV-related information. Most interventions to date have delivered SMS that do not overtly refer to HIV or ART in order to avoid risk of status disclosure. In formative work for an ongoing randomized controlled trial (RCT) evaluating one-way and two-way educational SMS for prevention of mother-to-child-transmission (PMTCT) adherence in Kenya, we conducted 10 focus group discussions (FGDs) with 87 HIV-infected peripartum women to determine desirability and preferred terminology of HIV-related content. SMS for the RCT were developed based on FGD findings. Roughly half of FGD participants supported receiving SMS containing overtly HIV-related terms, such as HIV and medication, citing desire for detailed educational messages about ART and PMTCT. Those opposed to overt content expressed concerns about confidentiality. Many participants argued that acceptability of HIV-related content depended on the recipient's disclosure status and others' access to her phone. Based on these findings, both covert and overt SMS were developed for the RCT and participants who owned their phone or had disclosed their HIV status to anyone with access to their phone were able to choose one of three options: (1) covert SMS only, (2) overt SMS only in response to HIV-related questions from the participant, (3) overt SMS routinely, initiated by the study. Of the 825 participants in the RCT, 94% were eligible to receive overt SMS. Of these, 66% opted to receive routine overt SMS and 10% to receive participant-initiated overt SMS. These findings show there may be interest in overt HIV-related information by SMS when risk of status disclosure is low, and support use of messaging strategies that allows participant choice in HIV-related content while protecting against undesired disclosure.