SMS/GIS Integration for HIV Surveillance and Health Care Delivery

描述（由申请人提供）：拟议试点项目的目标是更好地了解地理信息系统（GIS）与手机短信技术相结合如何促进改善与预防母婴传播艾滋病毒（PMTCT）的联系，并缩短坦桑尼亚农村环境中诊断和抗逆转录病毒药物（ARV）持续治疗之间的时间。虽然在预防母婴传播方面取得了令人鼓舞的进展，但获得艾滋病毒咨询和检测的机会以及艾滋病毒检测呈阳性的母亲随后获得抗逆转录病毒治疗的机会仍然各不相同。正在出现的研究强调了移动电话在整个撒哈拉以南非洲改善艾滋病毒诊断、预防和坚持治疗方面的潜力，并有更多证据说明了在艾滋病毒护理中使用地理信息系统（GIS）的效用。通过结合这些技术，互动和动态系统可用于：促进对提供护理的实时响应，在出现紧急感染的地区建立艾滋病毒VCT，增加向地区医院的转诊，并通知分配额外的药物和治疗

DESCRIPTION (provided by applicant): The goal of the proposed pilot project is to better understand how geographic information systems (GIS) integrated with SMS cell-phone technology can facilitate improvements in linkage to Prevention of Mother to Child Transmission of HIV (PMTCT) and reduce time between diagnosis and consistent treatment with antiretrovirals (ARV) in a rural setting in Tanzania. While promising improvements in PMTCT have occurred, there remains varied access to HIV counseling and testing and subsequent access to antiretroviral treatment for mothers testing positive for HIV. Research is emerging that underscores the potential for mobile phones to improve HIV diagnosis, prevention, and adherence to treatment throughout Sub-Saharan Africa and additional evidence illustrates the utility of using geographic information systems (GIS) in HIV care. Through combining these technologies, the interactive and dynamic system can be used to: facilitate real-time responses to delivery of care, to establish HIV VCT in areas with emergent infections, to increase referrals to the District Hospital, and to inform the distribution of additional medication and treatment for mothers and infants for facilitation of PMTCT. Guided by the Diffusion of Innovation (DI) Theory, the proposed pilot project will achieve a baseline for a subsequent randomized controlled trial that will test the efficacy of a culturally sensitive, technologically relevant PMTCT program for Misungwi, Tanzania. The pilot will develop and test a mobile phone-based record keeping system that will interface with existing GIS resource maps to facilitate and document delivery of PMTCT and VCT in Misungwi. The system will be implemented in the district over a 3-month period in order to establish how well the system works. The implementation phase will be followed by evaluation of the system with respect to the HIV treatment cascade, including whether an increased number of new HIV infections are identified, if the time is reduced between HIV diagnosis and start of treatment for women of childbearing age, and whether increased adherence to medication among female clients of HW using the mobile phone based tools occurs. We anticipate that this interactive and dynamic system will contribute to best practices in PMTCT by facilitating improved responses to delivery of care in these rural settings, assisting in locating additional HIV PMTCT programs in areas with emergent infections, and informing the distribution of additional medication and treatment for mothers. The explicit design of the study provides a model that could be scaled up in Tanzania and other East African settings. Additionally, if successful, the proposed approach holds great potential for replication to other priority populations for HIV and other health outcomes.