eHealth for Stigma Reduction Efforts Designed to Improve Engagement in Care for People Living with HIV

Rao, Deepa; Frey, Sarah; Ramaiya, Megan

doi:10.1007/s11904-018-0414-z

Cited by 17 publications

(10 citation statements)

References 31 publications

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“…Smartphone-based applications have helped to reduce internalized stigma and thus enhance follow-up and adher-ence to antiretroviral therapy in persons living with HIV infection. [31][32][33] These apps provided educational information and assistance in managing symptoms, reminders for medication schedule, promoted physical activity, healthy foods, and stress management.…”

Section: Impact On Stigma and Discriminationmentioning

confidence: 99%

Patient’s Perspectives of Telepsychiatry: The Past, Present and Future

Naik

Manjunatha

Kumar

et al. 2020

Indian Journal of Psychological Medicine

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Access to mental health care has significant disparities due to treatment gap, more so particularly for the remotely residing, physically vulnerable, aging populations. Adoption of technology will enable more people to receive specialty care addressing distance, transportation and cost-related barriers to treatment engagement from the comfort of home. Telemedicine has been regarded as “electronic personal protective equipment” by reducing the number of physical contacts and risk contamination for patients during COVID-19 crisis. This review aimed to give a broad view of patients’ perception of the use of telepsychiatry in terms of clinical outcome, cost-effectiveness, and solutions to address patients’ challenges with the adoption of technology. Over the years, telepsychiatry, both in synchronous and asynchronous modalities, had shown to improve patients’ adherence to treatment, follow-up rates, and clinical symptoms, overcome stigma and discrimination, and save cost expenses accessing health care with better satisfaction and usability outcomes. Its utility is widespread such as in delivering care emergency evaluation, crisis intervention, conducting neuropsychological assessments, psychotherapy, promoting lifestyle modification, enhancing self-efficacy, and overcoming patients’ linguistic and cultural barriers to care. However, patients’ privacy and confidentiality and psychiatrists’ legal liability remain as matter of major concern in digital platform. To keep up with the pace of technology and patients’ expectations, a more agile approach is essential to develop, improve, and evaluate telepsychiatric interventions.

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Section: Impact On Stigma and Discriminationmentioning

confidence: 99%

Patient’s Perspectives of Telepsychiatry: The Past, Present and Future

Naik

Manjunatha

Kumar

et al. 2020

Indian Journal of Psychological Medicine

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“…The advantages of using mHealth interventions are their low cost, making them suitable for use in low-and middle-income countries (LMIC), along with their convenience and accessibility. Besides, mHealth can provide users with a private space to curb the discrimination and stigma associated with HIV [32][33][34][35]. However, the path to mHealth incorporation into clinical care is fraught with many challenges [36].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of mobile phone text message reminder interventions to improve adherence to antiretroviral therapy among adolescents living with HIV: A systematic review and meta-analysis

et al. 2021

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Background Poor adherence to antiretroviral therapy in adolescents living with HIV is a global challenge. One of the key strategies to improve adherence is believed to be the use of digital adherence tools. However, evidence is limited in this area. Our objective was to investigate the effectiveness of mobile phone text message reminders in improving ART adherence for adolescents. Methods The preferred reporting item for systematic review and meta-analysis guideline was followed. A literature search was done in five databases (PubMed, Web of Science, Embase, Global Health and Cochrane) in August 2020. Additional searches for studies and grey literature were performed manually. We included studies with quantitative design exploring the effectiveness of text message reminders, targeting adolescents aged 10–19 years. Studies were excluded if the intervention involved phone calls, phone-based applications, or other complex tech services. Mean differences between intervention and standard of care were computed using a random effects model. Subgroup analyses were performed to identify sources of heterogeneity between one-way and two-way text messages. Results Of 2517 study titles screened, seven eligible studies were included in the systematic review. The total number of participants in the included studies was 987, and the study sample varied from 14 to 332. Five studies showed a positive impact of text messaging in improving adherence, while no significant difference was found between the intervention and the control (standard of care) group in the remaining two studies. The pooled mean difference between the intervention and the control group was 0.05 (95% CI: –0.08 to 0.17). There was considerable heterogeneity among the studies (I2 = 78%). Conclusion and recommendation The meta-analysis of text message reminder interventions did not show a statistically significant difference in the improvement of ART adherence among adolescents living with HIV. The included studies were heterogeneous in the reported clinical outcomes, where the effectiveness of the intervention was identified in small studies which had a short follow-up period. Studies with bigger sample size and a longer follow-up period are needed.

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“…Stigma intervention development has been challenging due to the multidimensional and multi-level nature of stigma (26) and ineffectual means to comprehensively intervene with participants in sustainable ways that go beyond simple education or information giving. Implementation of HIV-stigma interventions that require in-person attendance can be hampered by intervention access including distance-barriers, particularly in resourcepoor settings (27). Participants currently experiencing or anticipating high levels of stigma may also face additional obstacles, including reduced resources, social isolation, and maladaptive coping responses including avoidance and substance use that may serve as additional barriers to participation (10).…”

Section: Introductionmentioning

confidence: 99%

“…Finally, it is relevant to note that many youth in the US experience social connectedness through mobile technologies (39), thus facilitating contact with peers who may be experiencing similar stigmas could provide new and meaningful social support. mHealth has been leveraged for interventions to reduce HIV-related stigma, yet literature in this area is still scant (27) and the extent to which existing interventions have specifically engaged youth in stigma reduction efforts is unknown. This paper provides the first review of mHealth interventions for youth in the US that aimed, as an outcome or as part of the framing or conceptual model for the intervention, to reduce stigma as a way to improve HIV-related outcomes.…”

Section: Introductionmentioning

confidence: 99%

mHealth to reduce HIV-related stigma among youth in the United States: a scoping review

Mulawa¹,

Rosengren²,

Amico³

et al. 2021

mHealth

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Multiple intersecting stigmas and discrimination related to sex, gender, HIV, and race/ethnicity may challenge HIV prevention and treatment service utilization, particularly among youth. This scoping review describes recent and ongoing innovative mobile health (mHealth) interventions among youth in the United States that aim to reduce stigma as an outcome or as part of the intervention model. To identify examples of stigma-mitigation via mHealth, we searched peer-reviewed published literature using keyword strategies related to mHealth, HIV, stigma, and youth (ages 10 to 29). We identified eleven articles that met our inclusion criteria, including three describing data from two randomized controlled trials (RCTs), five describing pilot studies, one describing the process evaluation of an ongoing intervention, one describing formative work for intervention development, and one published study protocol for an ongoing intervention.We review these articles, grouped by HIV prevention and care continuum stages, and describe the mHealth approach used, including telehealth, simulation video games, motion comics, smartphone applications (apps), social media forums, online video campaigns, video vignettes, and a computerized behavioral learning module. Four studies focused on preventing primary acquisition through individual-level behavior change (e.g., reducing condomless anal intercourse), three focused on increasing HIV testing, three focused on linking to prevention services [e.g., pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP)] and one focused on promoting adherence to antiretroviral therapy (ART). Our review did not identify any published studies using mHealth with a primary aim to reduce stigma as a way to improve care engagement and increase viral suppression among youth in the United States. Additional RCTs and implementation studies examining the effectiveness of mHealth stigma-reduction interventions on HIV-related outcomes are needed to end the HIV epidemic among youth. mHealth offers unique advantages to address the complex intersecting stigma barriers along the HIV continuum to improve HIV-related outcomes for youth.

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eHealth for Stigma Reduction Efforts Designed to Improve Engagement in Care for People Living with HIV

Cited by 17 publications

References 31 publications

Patient’s Perspectives of Telepsychiatry: The Past, Present and Future

Patient’s Perspectives of Telepsychiatry: The Past, Present and Future

Effectiveness of mobile phone text message reminder interventions to improve adherence to antiretroviral therapy among adolescents living with HIV: A systematic review and meta-analysis

mHealth to reduce HIV-related stigma among youth in the United States: a scoping review

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