1275. Will an App-Optimized HIV Self-testing Strategy Work for South Africans? Results From a Large Cohort Study

Pai, Nitika Pant; Esmail, Ali; Marathe, Gayatri; Oelofse, Suzette; Pretorius, Marietjie; Smallwood, Megan; Daher, Jana; Janssen, Ricky; Saha‐Chaudhuri, Paramita; Engel, Nora; Dheda, Keertan

doi:10.1093/ofid/ofy210.1108

Cited by 3 publications

(3 citation statements)

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“…Study participants recruited for this qualitative study came from two quantitatively based studies: one in Cape Town, South Africa (Pai et al, 2018 ), and one in Montréal, Canada (Pant Pai et al, 2018 ). The quantitative studies aimed to evaluate an app‐based HIV self‐testing strategy (HIVSmart!)…”

Section: Methodsmentioning

confidence: 99%

‘You're only there on the phone’? A qualitative exploration of community, affect and agential capacity in HIV self‐testing using a smartphone app

Janssen

Engel

Pai

et al. 2021

Sociology Health & Illness

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Mobile health (mHealth) technologies for HIV care are developed to provide diagnostic support, health education, risk assessment and self‐monitoring. They aim to either improve or replace part of the therapeutic relationship. Part of the therapeutic relationship is affective, with the emergence of feelings and emotion, yet little research on mHealth for HIV care focuses on affect and HIV testing practices. Furthermore, most of the literature exploring affect and care relations with the introduction of mHealth is limited to the European and Australian context. This article explores affective dimensions of HIV self‐testing using a smartphone app strategy in Cape Town, South Africa and Montréal, Canada. This study is based on observation notes, 41 interviews and 1 focus group discussion with study participants and trained HIV healthcare providers from two quantitative studies evaluating the app‐based self‐test strategy. Our paper reveals how fear, apathy, judgement, frustration and comfort arise in testing encounters using the app and in previous testing experiences, as well as how this relates to care providers and test materials. Attending to affective aspects of this app‐based self‐testing practice makes visible certain affordances and limitations of the app within the therapeutic encounter and illustrates how mHealth can contribute to HIV care.

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Section: Methodsmentioning

confidence: 99%

‘You're only there on the phone’? A qualitative exploration of community, affect and agential capacity in HIV self‐testing using a smartphone app

Janssen

Engel

Pai

et al. 2021

Sociology Health & Illness

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“…app. The aim of the cohort study was to evaluate whether the app-based oral HIVST strategy improved referrals, detected new infections, and/or expedited linkages to care and treatment compared to conventional HIV testing through a healthcare provider (Pai et al 2018).…”

Section: Introductionmentioning

confidence: 99%

“…strategy. While the team on the quantitative arm of the study gathered numerical data on aspects such as the number of new infections detected, preferences regarding HIV self-testing strategies, and linkages to care (Pai et al 2018), RJ was responsible for gathering qualitative data on participants' experiences using the app and self-test and on study staff's experiences implementing the HIVSmart! strategy.…”

Section: Introductionmentioning

confidence: 99%

Moments of Uncertainty: Exploring How an App-Based Oral HIV Self-Testing Strategy Fits in Communities ‘Living Under’ HIV Risk

Janssen

Krumeich²,

Esmail³

et al. 2021

MAT

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Feasibility and acceptability research for HIV self-testing (HIVST) often emphasises the importance of good test conduct and correct test interpretation for knowing one’s HIV result while overlooking the ways in which different uncertainties and meanings emerge around testing. Using empirical examples from a quantitative study assessing an app-based strategy in Cape Town, South Africa, this research article explores the practice of HIVST and how people deal with uncertainties while using the app in question, named ‘HIVSmart!’. We use the concept of ‘living under’ to explore the practices of HIV testing for those who fit the definition of being ‘at risk’ of HIV (note that an individual’s HIV status must be unknown in order for them to fit this definition) and to understand how an app-based HIVST strategy fits within these practices. We show how the app and oral self-test—as well as knowledge around HIV risk behaviours, comparisons between different testing methods, and the guidance and presence of healthcare staff—alleviate as well as generate uncertainty and constitute HIV status as an ongoing process. The effective implementation of new strategies for HIVST requires consideration of multiple aspects of the testing process, including local understandings of HIV risk, access to healthcare staff, and the meaning of certain test methods within a particular context.

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Qualitative Evaluation of mHealth Implementation for Infectious Disease Care in Low- and Middle-Income Countries: Narrative Review

Greenall-Ota,

Yapa,

Fox

et al. 2024

JMIR Mhealth Uhealth

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Background Mobile health (mHealth) interventions have the potential to improve health outcomes in low- and middle-income countries (LMICs) by aiding health workers to strengthen service delivery, as well as by helping patients and communities manage and prevent diseases. It is crucial to understand how best to implement mHealth within already burdened health services to maximally improve health outcomes and sustain the intervention in LMICs. Objective We aimed to identify key barriers to and facilitators of the implementation of mHealth interventions for infectious diseases in LMICs, drawing on a health systems analysis framework. Methods We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist to select qualitative or mixed methods studies reporting on determinants of already implemented infectious disease mHealth interventions in LMICs. We searched MEDLINE, Embase, PubMed, CINAHL, the Social Sciences Citation Index, and Global Health. We extracted characteristics of the mHealth interventions and implementation experiences, then conducted an analysis of determinants using the Tailored Implementation for Chronic Diseases framework. Results We identified 10,494 titles for screening, among which 20 studies met our eligibility criteria. Of these, 9 studies examined mHealth smartphone apps and 11 examined SMS text messaging interventions. The interventions addressed HIV (n=7), malaria (n=4), tuberculosis (n=4), pneumonia (n=2), dengue (n=1), human papillomavirus (n=1), COVID-19 (n=1), and respiratory illnesses or childhood infectious diseases (n=2), with 2 studies addressing multiple diseases. Within these studies, 10 interventions were intended for use by health workers and the remainder targeted patients, at-risk individuals, or community members. Access to reliable technological resources, familiarity with technology, and training and support were key determinants of implementation. Additional themes included users forgetting to use the mHealth interventions and mHealth intervention designs affecting ease of use. Conclusions Acceptance of the intervention and the capacity of existing health care system infrastructure and resources are 2 key factors affecting the implementation of mHealth interventions. Understanding the interaction between mHealth interventions, their implementation, and health systems will improve their uptake in LMICs.

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1275. Will an App-Optimized HIV Self-testing Strategy Work for South Africans? Results From a Large Cohort Study

Cited by 3 publications

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‘You're only there on the phone’? A qualitative exploration of community, affect and agential capacity in HIV self‐testing using a smartphone app

‘You're only there on the phone’? A qualitative exploration of community, affect and agential capacity in HIV self‐testing using a smartphone app

Moments of Uncertainty: Exploring How an App-Based Oral HIV Self-Testing Strategy Fits in Communities ‘Living Under’ HIV Risk

Qualitative Evaluation of mHealth Implementation for Infectious Disease Care in Low- and Middle-Income Countries: Narrative Review

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