scholarly journals Development of PositiveLinks: A Mobile Phone App to Promote Linkage and Retention in Care for People With HIV (Preprint)

2018 ◽  
Author(s):  
Colleen Laurence ◽  
Erin Wispelwey ◽  
Tabor E Flickinger ◽  
Marika Grabowski ◽  
Ava Lena Waldman ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Retention In Care ◽  
Hiv Care ◽  
Just In Time ◽  
People Living With Hiv ◽  
Message Board ◽  
Retention In Hiv Care ◽  
High Participation ◽  
Living With Hiv ◽  
Usability Feedback

BACKGROUND Linkage to and retention in HIV care are challenging, especially in the Southeastern United States. The rise in mobile phone app use and the potential for an app to deliver just in time messaging provides a new opportunity to improve linkage and retention among people living with HIV (PLWH). OBJECTIVE This study aimed to develop an app to engage, link, and retain people in care. We evaluated the acceptability, feasibility, and impact of the app among users. METHODS App development was informed by principles of chronic disease self-management and formative interviews with PLWH. Once developed, the app was distributed among participants, and usability feedback was incorporated in subsequent iterations. We interviewed app users after 3 weeks to identify usability issues, need for training on the phone or app, and to assess acceptability. We tracked and analyzed usage of app features for the cohort over 2 years. RESULTS A total of 77 participants used the app during the pilot study. The query response rate for the first 2 years was 47.7%. Query response declined at a rate of 0.67% per month. The community message board was the most popular feature, and 77.9% (60/77) of users posted on the board at least once during the 2 years. CONCLUSIONS The PositiveLinks app was feasible and acceptable among nonurban PLWH. High participation on the community message board suggests that social support from peers is important for people recently diagnosed with or returning to care for HIV.

scholarly journals 1322. A Mobile Technology-Based Intervention Improves HIV Care Continuum for Young People Living with HIV

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S478-S478
Author(s):  
Ping Du ◽  
John Zurlo ◽  
Tarek Eshak ◽  
Tonya Crook ◽  
Cynthia Whitener
Keyword(s):  
Mobile Technology ◽  
Viral Suppression ◽  
Retention In Care ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Care Continuum ◽  
Care Continuum ◽  
Hiv Viral Suppression ◽  
Study Participants ◽  
Living With Hiv

Abstract Background Young people living with HIV (YPLWH) have lower rates of retention in care and HIV viral suppression. Multiple barriers exist to engage YPLWH in care. As nearly all YPLWH use their mobile phones to access health information and to communicate with other people, we implemented a mobile technology-based intervention with the goal to improve HIV care continuum in YPLWH. Methods YPLWH were eligible for this study if they were: (1) aged 18–34 years; (2) newly diagnosed with HIV; (3) having a history of being out of care; or (4) not virally suppressed. We recruited YPLWH during January 2017-May 2018 and followed them every 6 months. We developed a HIPAA-compliant mobile application, “OPT-In For Life,” and let participants use this app to manage their HIV care. The app integrated multiple features that enabled users to communicate with the HIV treatment team via a secure messaging function, to access laboratory results and HIV prevention resources, and to set up appointment or medication reminders. We obtained participants’ demographics, app-usage data, and medical records to evaluate if this mobile technology-based intervention would improve HIV care continuum among YPLWH. We used a quasi-experiment study design to compare the rates of retention in care and HIV viral suppression every 6 months between study participants and YPLWH who were eligible but not enrolled in the study. Results 92 YPLWH participated in this study (70% male, 56% Hispanics or Blacks, 54% retained in care, and 66% virally suppressed at baseline). On average study participants used the app 1–2 times/week to discuss various health issues and supportive services with HIV providers, to access HIV-related health information, and to manage their HIV care. At the 6-month evaluation, compared with 88 eligible YPLWH who were not enrolled in this intervention, study participants had increased rates of retention in care (baseline-to-6-month between participants and nonparticipants: 54%–84% vs. 26%–25%) and HIV viral suppression (66%–80% vs. 56%–60%). Conclusion Our study demonstrates using a HIPAA-compliant mobile app as an effective intervention to engage YPLWH in care. This intervention can be adapted by other HIV programs to improve HIV care continuum for YPLWH or broader HIV populations. Disclosures All authors: No reported disclosures.

scholarly journals Estimating the HIV undiagnosed population in Catalonia, Spain: descriptive and comparative data analysis to identify differences in MSM stratified by migrant and Spanish-born population

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018533 ◽  
Author(s):  
Juliana Maria Reyes-Urueña ◽  
Colin N J Campbell ◽  
Núria Vives ◽  
Anna Esteve ◽  
Juan Ambrosioni ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Retention In Care ◽  
Hiv And Aids ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Care Cascade ◽  
Care Cascade ◽  
Undiagnosed Hiv ◽  
Sex With Men ◽  
Living With Hiv

ObjectiveUndiagnosed HIV continues to be a hindrance to efforts aimed at reducing incidence of HIV. The objective of this study was to provide an estimate of the HIV undiagnosed population in Catalonia and compare the HIV care cascade with this step included between high-risk populations.MethodsTo estimate HIV incidence, time between infection and diagnosis and the undiagnosed population stratified by CD4 count, we used the ECDC HIV Modelling Tool V.1.2.2. This model uses data on new HIV and AIDS diagnoses from the Catalan HIV/AIDS surveillance system from 2001 to 2013. Data used to estimate the proportion of people enrolled, on ART and virally suppressed in the HIV care cascade were derived from the PISCIS cohort.ResultsThe total number of people living with HIV (PLHIV) in Catalonia in 2013 was 34 729 (32 740 to 36 827), with 12.3% (11.8 to 18.1) of whom were undiagnosed. By 2013, there were 8458 (8101 to 9079) Spanish-born men who have sex with men (MSM) and 2538 (2334 to 2918) migrant MSM living with HIV in Catalonia. A greater proportion of migrant MSM than local MSM was undiagnosed (32% vs 22%). In the subsequent steps of the HIV care cascade, migrants MSM experience greater losses than the Spanish-born MSM: in retention in care (74% vs 55%), in the proportion on combination antiretroviral treatment (70% vs 50%) and virally suppressed (65% vs 46%).ConclusionsBy the end of 2013, there were an estimated 34 729 PLHIV in Catalonia, of whom 4271 were still undiagnosed. This study shows that the Catalan epidemic of HIV has continued to expand with the key group sustaining HIV transmission being MSM living with undiagnosed HIV.

scholarly journals Association Between Depression and HIV Care Engagement Outcomes Among Patients Newly Initiating ART in Lilongwe, Malawi

2020 ◽  
Author(s):  
Melissa A. Stockton ◽  
Bradley N. Gaynes ◽  
Mina C. Hosseinipour ◽  
Audrey E. Pettifor ◽  
Joanna Maselko ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Load Testing ◽  
Art Initiation ◽  
Retention In Hiv Care ◽  
Hiv Care Engagement ◽  
Care Outcomes ◽  
Sub Saharan ◽  
Living With Hiv

Abstract As in other sub-Saharan countries, the burden of depression is high among people living with HIV in Malawi. However, the association between depression at ART initiation and two critical outcomes—retention in HIV care and viral suppression—is not well understood. Prior to the launch of an integrated depression treatment program, adult patients were screened for depression at ART initiation at two clinics in Lilongwe, Malawi. We compared retention in HIV care and viral suppression at 6 months between patients with and without depression at ART initiation using tabular comparison and regression models. The prevalence of depression among this population of adults newly initiating ART was 27%. Those with depression had similar HIV care outcomes at 6 months to those without depression. Retention metrics were generally poor for those with and without depression. However, among those completing viral load testing, nearly all achieved viral suppression. Depression at ART initiation was not associated with either retention or viral suppression. Further investigation of the relationship between depression and HIV is needed to understand the ways depression impacts the different aspects of HIV care engagement.

scholarly journals Exploring the Patterns of Use and Acceptability of Mobile Phones Among People Living With HIV to Improve Care and Treatment: Cross-Sectional Study in Three Francophone West African Countries

10.2196/13741 ◽  
2019 ◽  
Vol 7 (11) ◽  
pp. e13741
Author(s):  
Phillipe Lepère ◽  
Yélamikan Touré ◽  
Alexandra M Bitty-Anderson ◽  
Simon P Boni ◽  
Gildas Anago ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
West African ◽  
Hiv Care ◽  
People Living With Hiv ◽  
African Countries ◽  
Cross Sectional ◽  
Factors Associated ◽  
Living With Hiv

Background The use of mobile technology in health care (mobile health [mHealth]) could be an innovative way to improve health care, especially for increasing retention in HIV care and adherence to treatment. However, there is a scarcity of studies on mHealth among people living with HIV (PLHIV) in West and Central Africa. Objective The aim of this study was to assess the acceptability of an mHealth intervention among PLHIV in three countries of West Africa. Methods A cross-sectional study among PLHIV was conducted in 2017 in three francophone West African countries: Côte d’Ivoire, Burkina Faso, and Togo. PLHIV followed in the six preselected HIV treatment and care centers, completed a standardized questionnaire on mobile phone possession, acceptability of mobile phone for HIV care and treatment, preference of mobile phone services, and phone sharing. Descriptive statistics and logistic regression were used to describe variables and assess factors associated with mHealth acceptability. Results A total of 1131 PLHIV—643 from Côte d’Ivoire, 239 from Togo, and 249 from Burkina Faso—participated in the study. Median age was 44 years, and 76.1% were women (n=861). Almost all participants owned a mobile phone (n=1107, 97.9%), and 12.6% (n=140) shared phones with a third party. Acceptability of mHealth was 98.8%, with the majority indicating their preference for both phone calls and text messages. Factors associated with mHealth acceptability were having a primary school education or no education (adjusted odds ratio=7.15, 95% CI 5.05-10.12; P<.001) and waiting over one hour before meeting a medical doctor on appointment day (adjusted odds ratio=1.84, 95% CI 1.30-2.62; P=.01). Conclusions The use of mHealth in HIV treatment and care is highly acceptable among PLHIV and should be considered a viable tool to allow West and Central African countries to achieve the Joint United Nations Programme on HIV/AIDS 90-90-90 goals.

scholarly journals Exploring the Patterns of Use and Acceptability of Mobile Phones Among People Living With HIV to Improve Care and Treatment: Cross-Sectional Study in Three Francophone West African Countries (Preprint)

2019 ◽  
Author(s):  
Phillipe Lepère ◽  
Yélamikan Touré ◽  
Alexandra M Bitty-Anderson ◽  
Simon P Boni ◽  
Gildas Anago ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
West African ◽  
Hiv Care ◽  
People Living With Hiv ◽  
African Countries ◽  
Cross Sectional ◽  
Factors Associated ◽  
Living With Hiv

BACKGROUND The use of mobile technology in health care (mobile health [mHealth]) could be an innovative way to improve health care, especially for increasing retention in HIV care and adherence to treatment. However, there is a scarcity of studies on mHealth among people living with HIV (PLHIV) in West and Central Africa. OBJECTIVE The aim of this study was to assess the acceptability of an mHealth intervention among PLHIV in three countries of West Africa. METHODS A cross-sectional study among PLHIV was conducted in 2017 in three francophone West African countries: Côte d’Ivoire, Burkina Faso, and Togo. PLHIV followed in the six preselected HIV treatment and care centers, completed a standardized questionnaire on mobile phone possession, acceptability of mobile phone for HIV care and treatment, preference of mobile phone services, and phone sharing. Descriptive statistics and logistic regression were used to describe variables and assess factors associated with mHealth acceptability. RESULTS A total of 1131 PLHIV—643 from Côte d’Ivoire, 239 from Togo, and 249 from Burkina Faso—participated in the study. Median age was 44 years, and 76.1% were women (n=861). Almost all participants owned a mobile phone (n=1107, 97.9%), and 12.6% (n=140) shared phones with a third party. Acceptability of mHealth was 98.8%, with the majority indicating their preference for both phone calls and text messages. Factors associated with mHealth acceptability were having a primary school education or no education (adjusted odds ratio=7.15, 95% CI 5.05-10.12; <italic>P</italic>&lt;.001) and waiting over one hour before meeting a medical doctor on appointment day (adjusted odds ratio=1.84, 95% CI 1.30-2.62; <italic>P</italic>=.01). CONCLUSIONS The use of mHealth in HIV treatment and care is highly acceptable among PLHIV and should be considered a viable tool to allow West and Central African countries to achieve the Joint United Nations Programme on HIV/AIDS 90-90-90 goals.

scholarly journals Travel time to Clinic but not Neighborhood Crime Rate is associated with Retention in Care among HIV-positive Patients

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S421-S421
Author(s):  
Jessica P Ridgway ◽  
Ellen Almirol ◽  
Jessica Schmitt ◽  
Todd Schuble ◽  
John Schneider
Keyword(s):  
Travel Time ◽  
Public Transportation ◽  
Crime Rate ◽  
Viral Suppression ◽  
Retention In Care ◽  
Travel Distance ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Neighborhood Crime ◽  
Retention In Hiv Care

Abstract Background Retention in HIV care can be impacted by structural factors such as crime, poverty, and clinic accessibility. We aimed to determine whether crime rate, travel time, or travel distance to clinic were associated with retention in care or viral suppression (VS) among people living with HIV (PLWH) at the largest provider of HIV care on the South Side of Chicago. Methods Using publicly available data in the Chicago Open Data Portal, we geocoded patient home addresses and clinic location. We measured distance from patient home to clinic, and travel time from patient home to clinic using car and Chicago Transit Authority (CTA) public transportation. We further measured crime rate within a two block radius of the public transportation route to clinic. Retention was defined as &gt;2 visits, 90 days apart within 12 months, and patients were classified into 3 groups: continuously retained (CR), intermittently retained (IR), or lost to follow-up (LTFU), i.e., no visit in the last 12-months. Kruskal–Wallis rank-sum with Dunns pairwise test was used to determine whether travel time, travel distance, and crime rate were associated with retention or viral suppression. Results 780 patients were included in the study. Of these 273 (35%) were CR, 392 (50%) were IR, and 115 (15%) were LTFU. Figure 1 shows maps with geocoded data. Median distance from clinic was 3.6 [2.1–5.6] miles among those CR, 3.9 [2.5–6.0] miles among the IR, and 3.9 [2.6–6.2] miles among those LTFU. Median travel time by CTA was 37.2 [31.8–53.0] mins for CR, 42.9 [33–53] mins for IR, and 42.9 [33–59.1] mins for LTFU; by car was 15.9 [9.6–33] mins for CR, 17.1 [11.8–24.6] mins for IR, and 17.5 [12.2–24.1] mins for LTFU. Crime rate was similar across all retention groups. Though no associations were statistically significant at P &lt; 0.05, there was a trend toward shorter distance (P = 0.07) and shorter car travel time (P = 0.06) among CR vs. IR. There was also a trend toward lower neighborhood crime rates among those VS vs. those not VS (P = 0.07). Conclusion Retention in care was not impacted by residing in high crime neighborhoods in Chicago. PLWHA who lived farther from HIV clinic and had longer travel time showed a trend toward being more likely to be IR in care vs. CR, but there was no such association for VS. Travel time may impact patient likelihood to attend HIV care appointments, but not necessarily adherence to ART. Disclosures J. P. Ridgway, Gilead FOCUS: Grant Investigator, Grant recipient

scholarly journals Practical and Ethical Concerns in Implementing Enhanced Surveillance Methods to Improve Continuity of HIV Care: Qualitative Expert Stakeholder Study (Preprint)

2020 ◽  
Author(s):  
Mara Buchbinder ◽  
Colleen Blue ◽  
Stuart Rennie ◽  
Eric Juengst ◽  
Lauren Brinkley-Rubinstein ◽  
...  
Keyword(s):  
A Priori ◽  
The United States ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Ethical Concerns ◽  
Retention In Hiv Care ◽  
Semistructured Interviews ◽  
Privacy And Confidentiality ◽  
Living With Hiv

BACKGROUND Retention in HIV care is critical to maintaining viral suppression and preventing further transmission, yet less than 50% of people living with HIV in the United States are engaged in care. All US states have a funding mandate to implement Data-to-Care (D2C) programs, which use surveillance data (eg, laboratory, Medicaid billing) to identify out-of-care HIV-positive persons and relink them to treatment. OBJECTIVE The purpose of this qualitative study was to identify and describe practical and ethical considerations that arise in planning for and implementing D2C. METHODS Via purposive sampling, we recruited 43 expert stakeholders—including ethicists, privacy experts, researchers, public health personnel, HIV medical providers, legal experts, and community advocates—to participate in audio-recorded semistructured interviews to share their perspectives on D2C. Interview transcripts were analyzed across a priori and inductively derived thematic categories. RESULTS Stakeholders reported practical and ethical concerns in seven key domains: permission and consent, government assistance versus overreach, privacy and confidentiality, stigma, HIV exceptionalism, criminalization, and data integrity and sharing. CONCLUSIONS Participants expressed a great deal of support for D2C, yet also stressed the role of public trust and transparency in addressing the practical and ethical concerns they identified. CLINICALTRIAL

scholarly journals Predictors of Linkage to and Retention in HIV Care Following Release from Connecticut Jails and Prisons

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S38-S38
Author(s):  
Kelsey B Loeliger ◽  
Frederick L Altice ◽  
Mayur M Desai ◽  
Maria M Ciarleglio ◽  
Colleen Gallagher ◽  
...  
Keyword(s):  
Case Management ◽  
Viral Suppression ◽  
Linkage To Care ◽  
Retention In Care ◽  
Hiv Treatment ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Hiv Surveillance ◽  
Targeted Interventions ◽  
Retention In Hiv Care

Abstract Background One in six people living with HIV (PLH) in the USA transition through prison or jail annually. During incarceration, people may engage in HIV care, but transition to the community remains challenging. Linkage to care (LTC) post-release and retention in care (RIC) are necessary to optimizing HIV outcomes, but have been incompletely assessed in prior observational studies. Methods We created a retrospective cohort of all PLH released from a Connecticut jail or prison (2007–2014) by linking Department of Correction demographic, pharmacy, and custody databases with Department of Public Health HIV surveillance monitoring and case management data. We assessed time to LTC, defined as time from release to first community HIV-1 RNA test, and viral suppression status at time of linkage. We used generalized estimating equations to identify correlates of LTC within 14 or 30 days after release. We also described RIC over three years following an initial release, comparing recidivists to non-recidivists. Results Among 3,302 incarceration periods from 1,350 unique PLH, 21% and 34% had LTC within 14 and 30 days, respectively, of which &gt;25% had detectable viremia at time of linkage. Independent correlates of LTC at 14 days included incarceration periods &gt;30 days (adjusted odds ratio [AOR] = 1.6; P &lt; 0.001), higher medical comorbidity (AOR = 1.8; P &lt; 0.001), antiretrovirals prescribed before release (AOR = 1.5; P = 0.001), transitional case management (AOR = 1.5; P &lt; 0.001), re-incarceration (AOR = 0.7; P = 0.002) and conditional release (AOR = 0.6; P &lt; 0.001). The 30-day model additionally included psychiatric comorbidity (AOR = 1.3; P = 0.016) and release on bond (AOR = 0.7; P = 0.033). Among 1,094 PLH eligible for 3-year follow-up, RIC after release declined over 1 year (67%), 2 years (51%) and 3 years (42%). Recidivists were more likely than nonrecidivists to have RIC but, among those retained, were less likely to be virally suppressed (Figure 1). Conclusion For incarcerated PLH, both LTC and RIC as well as viral suppression are suboptimal after release. PLH who receive case management are more likely to have timely LTC. Targeted interventions and integrated programming aligning health and criminal justice goals may improve post-release HIV treatment outcomes. Disclosures All authors: No reported disclosures.

scholarly journals Why do patients interrupt and return to antiretroviral therapy? Retention in HIV care from the patient’s perspective in Johannesburg, South Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256540
Author(s):  
Melanie A. Bisnauth ◽  
Natasha Davies ◽  
Sibongile Monareng ◽  
Fezile Buthelezi ◽  
Helen Struthers ◽  
...  
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Health Services ◽  
Healthcare Providers ◽  
Retention In Care ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Structured Interviews ◽  
Related Factors ◽  
Retention In Hiv Care

Background Retention in care is required for optimal clinical outcomes in people living with HIV (PLHIV). Although most PLHIV in South Africa know their HIV status, only 70% are on antiretroviral therapy (ART). Improved retention in care is needed to get closer to sustained ART for all. In January 2019, Anova Health Institute conducted a campaign to encourage patients who had interrupted ART to return to care. Methods Data collection was conducted in one region of Johannesburg. This mixed methods study consisted of two components: 1) healthcare providers entered data into a structured tool for all patients re-initiating ART at nine clinics over a nine-month period, 2) Semi-structured interviews were conducted with a sub-set of patients. Responses to the tool were analysed descriptively, we report frequencies, and percentages. A thematic approach was used to analyse participant experiences in-depth. Results 562 people re-initiated ART, 66% were women, 75% were 25–49 years old. The three most common reasons for disengagement from care were mobility (30%), ART related factors (15%), and time limitations due to work (10%). Reasons for returning included it becoming easier to attend the clinic (34%) and worry about not being on ART (19%). Mobile interview participants often forgot their medical files and expressed that managing their ART was difficult because they often needed a transfer letter to gain access to ART at another facility. On the other hand, clinics that had flexible and extended hours facilitated retention in care. Conclusion In both the quantitative data, and the qualitative analysis, changing life circumstances was the most prominent reason for disengagement from care. Health services were not perceived to be responsive to life changes or mobility, leading to disengagement. More client-centred and responsive health services should improve retention on ART.

Provision of Isoniazid Preventive Therapy: The Experiences of People Living with HIV

2020 ◽  
Vol 21 (2) ◽  
Author(s):  
Keamogetse Selehelo ◽  
Lufuno Makhado ◽  
Karabo Angel Madiba
Keyword(s):  
South Africa ◽  
Health Centre ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
World Health ◽  
Hiv Care ◽  
People Living With Hiv ◽  
North West ◽  
Retention In Hiv Care ◽  
Living With Hiv

Isoniazid preventive therapy (IPT) is a strategy that has been proposed by the National Department of Health of South Africa and the World Health Organization for people living with HIV (PLWH) to prevent latent tuberculosis (TB) progressing to active TB. This research focused on exploring and describing experiences of PLWH regarding IPT provision in the Ngaka Modiri Molema district in the North West province of South Africa. A qualitative, exploratory, contextual and descriptive research design was used for this study. Semi-structured individual interviews were conducted to collect data from PLWH. The sample size consisted of 14 participants and data saturation was reached at participant 11. A thematic data analysis was employed in this study. The study consisted of 10 female participants and 4 male participants. Three main themes emerged during interviews, namely factors that facilitate IPT provision and uptake, factors that inhibit the adherence of patients to IPT, and strategies to improve provision or adherence. The provision of IPT at a community health centre in Ngaka Modiri Molema district municipality was reported to be satisfactorily although challenges were also marked. IPT must be available at all times to ensure the promotion of PLWH adherence, continuity of care and retention in HIV care. In addition, screening of PLWH for active TB disease before they can be initiated should be a priority. PLWH should be supported and followed up through the directly observed treatment, short-course strategy to promote adherence and this can also be facilitated through adherence social clubs.

Sign in / Sign up

Export Citation Format

Share Document