Telehealth Interventions for HIV in Low- and Middle-Income Countries

Kim, Sang-Min; Linh, Đoàn Thị Thùy; Cosimi, Lisa A.; Pollack, Todd

doi:10.1007/s11904-022-00630-0

Cited by 16 publications

(11 citation statements)

References 63 publications

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“…13–29 There have been relatively few reports in the literature on PrEP telehealth outside the United States, but efforts have been described in Brazil, Vietnam, Thailand, Germany, and Kenya. 27,30,31…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of PrEPTECH: Findings From a 180-Day Randomized Controlled Trial of a Pre-Exposure Prophylaxis Telehealth Intervention

Erenrich,

Braun,

Torres-Mendoza

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Telehealth approaches are increasingly being used to provide access to pre-exposure prophylaxis (PrEP), an effective but underused HIV prevention modality. This randomized controlled trial of PrEPTECH, a telehealth intervention for the provision of HIV PrEP, seeks to assess its effects on PrEP access.Methods: Young men who have sex with men and transgender women in Florida and California with an indication for PrEP were randomly assigned in a 1:1 allocation to receive access to PrEPTECH or a control condition, access to an online listing of PrEP resources in their communities. This intent-to-treat analysis used logistic and linear regression to compare self-reported PrEP initiation, use, and coverage between control and intervention arm participants at 90 days and 180 days of follow-up.Results: A total of 229 participants with a mean age of 23.7 years, 77.3% people of color enrolled in PrEPTECH. At 90 days, postbaseline initiation of PrEP was significantly higher among those in the PrEPTECH arm than among controls (odds ratio [OR]: 6.63, 95% confidence interval [CI]: 2.54 to 17.35), and this held true by 180 days post baseline. The count of sex acts for which participants were not protected by PrEP, PrEP adherence, and recent PrEP use at 180 days post baseline were not significantly different between the study arms. Conclusions:Receiving access to a telehealth platform for PrEP access increased PrEP initiation in this cohort of young, predominantly non-White sexual and gender minorities. PrEP telehealth may be a worthy avenue for providing access to PrEP for these populations, but additional strategies may be needed to promote adherence and persistence of PrEP use.

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Section: Introductionmentioning

confidence: 99%

Effectiveness of PrEPTECH: Findings From a 180-Day Randomized Controlled Trial of a Pre-Exposure Prophylaxis Telehealth Intervention

Erenrich,

Braun,

Torres-Mendoza

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…One such intervention for HIV+ AYA in Western Kenya, demonstrated feasibility and acceptability; participants were provided with study funded smartphones preprogramed with the WhatsApp mobile platform to connect with peer support and counseling [ 75 ]. The scalability and sustainability of technology-enabled interventions for people living with HIV in LMIC will require training of health workers, infrastructure development, and evaluation of cost [ 76 ].…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Acceptability of the Adherence Connection Counseling, Education, and Support (ACCESS) Proof of Concept: A Peer-Led, Mobile Health (mHealth) Cognitive Behavioral Antiretroviral Therapy (ART) Adherence Intervention for HIV-Infected (HIV+) Adolescents and Young Adults (AYA)

et al. 2022

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Effective antiretroviral therapy (ART) adherence strategies for HIV+ adolescents and young adults (AYA) are needed to prevent HIV-related morbidity, mortality, and onward transmission. In the Adherence Connection for Counseling, Education, and Support (ACCESS) pilot, an exploratory sequential mixed-methods design was used to develop and test a peer-led, mobile health (mHealth) cognitive behavioral ART adherence intervention. HIV+ AYA (ages 16–29 years) with unsuppressed plasma HIV RNA (HIV viral load) were eligible for this five-session intervention directed to improving ART adherence and HIV viral load. A total of 78 peer-led remote videoconferencing sessions (via WebEx) were delivered to 16 participants. High completion rates (97.5%) and client satisfaction scores (mean = 29.13 of 32; SD = 2.45) were observed. Self-reported ART adherence improved (32% increase in doses taken; 95th CI 11.2–53.3) with an annualized average rate of 47.5% (0.28 log 10 ) reduction in HIV viral load. We established proof of concept for the ACCESS peer-led, mHealth cognitive behavioral ART adherence intervention, with promising adherence and virologic outcome data.

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“…Digital platforms, now integral for scheduling HIV prevention services and procuring ART refills, have demonstrated their impact. Under Kenya's EpIC initiative, online HIV case findings post-pandemic surged to 10% from a mere 5% pre-COVID-19, indicating the enduring potential of such digital tools ( 37 ).…”

Section: Leveraging Telehealth For Hiv Prevention Care and Support In...mentioning

confidence: 99%

“…Countries like Botswana, Eswatini, Rwanda, Tanzania, and Zimbabwe have commendably achieved the 95-95-95 UNAIDS benchmarks, with at least 16 other nations, including eight in sub-Saharan Africa, on the cusp of this accomplishment ( 37 ). These milestones pave the way for broader application of telehealth in enhancing HIV-related healthcare delivery.…”

Section: Leveraging Telehealth For Hiv Prevention Care and Support In...mentioning

confidence: 99%

“…Furthermore, the introduction of long-acting extended delivery (LAED) formulations like injectable cabotegravir (CAB-LA) and dapivirine vaginal ring (DPV-VR) has enriched the HIV prevention arsenal. These are especially critical for high-risk groups like AGYW ( 37 ). However, as the deployment of these formulations escalates in developing nations, potential side effects could arise, necessitating specialist consultations even in remote areas with the use of telehealth.…”

Section: Leveraging Telehealth For Hiv Prevention Care and Support In...mentioning

confidence: 99%

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Unlocking the potential of telehealth in Africa for HIV: opportunities, challenges, and pathways to equitable healthcare delivery

Cuadros,

Huang,

Mathenjwa

et al. 2024

Front. Digit. Health

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Telehealth Interventions for HIV in Low- and Middle-Income Countries

Cited by 16 publications

References 63 publications

Effectiveness of PrEPTECH: Findings From a 180-Day Randomized Controlled Trial of a Pre-Exposure Prophylaxis Telehealth Intervention

Effectiveness of PrEPTECH: Findings From a 180-Day Randomized Controlled Trial of a Pre-Exposure Prophylaxis Telehealth Intervention

Feasibility and Acceptability of the Adherence Connection Counseling, Education, and Support (ACCESS) Proof of Concept: A Peer-Led, Mobile Health (mHealth) Cognitive Behavioral Antiretroviral Therapy (ART) Adherence Intervention for HIV-Infected (HIV+) Adolescents and Young Adults (AYA)

Unlocking the potential of telehealth in Africa for HIV: opportunities, challenges, and pathways to equitable healthcare delivery

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