aDepartment of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill bCenter for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, North Carolina cDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota dFamily and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania eInstitute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Curr Opin HIV AIDS. 2017 Sep;12(5):432-441. doi: 10.1097/COH.0000000000000401.
PURPOSE OF REVIEW: We describe recent mobile health (mHealth) interventions supporting antiretroviral therapy (ART) medication adherence among HIV-positive MSM. RECENT FINDINGS: Keyword searches (1 January 2016-13 May 2017) identified 721 citations. Seven publications reporting on six studies met inclusion criteria. Five studies focused on MSM. Interventions primarily employed text messaging (n = 4), whereas two focused on smartphone apps and one on social media. Three studies measured intervention impact on adherence and found increased ART use intentions (n = 1), self-reported adherence (n = 1), and viral suppression (n = 1, no control group). Other mHealth interventions for HIV-positive MSM focused on status disclosure and reducing sexual risk. SUMMARY: mHealth interventions to support ART adherence among MSM show acceptability, feasibility, and preliminary efficacy. No recent mHealth interventions for MSM measured impact on viral suppression compared with a control condition despite earlier (pre-2015) evidence for efficacy. Studies are underway that include multiple features designed to improve adherence within complex smartphone or internet-based platforms. Areas for future growth include overcoming measurement and engagement challenges, developing tools for coordinating patient and provider adherence data, testing combination interventions, and adapting efficacious interventions for new languages and geographic settings.
目的综述：我们描述了最近支持 HIV 阳性男男性行为者（MSM）抗逆转录病毒治疗（ART）药物依从性的移动医疗（mHealth）干预措施。
最近的发现：关键词搜索（2016 年 1 月 1 日至 2017 年 5 月 13 日）确定了 721 条引文。符合纳入标准的有 7 篇报告了 6 项研究的出版物。五项研究侧重于 MSM。干预措施主要采用短信（n=4），而两项侧重于智能手机应用程序，一项侧重于社交媒体。三项研究衡量了干预措施对依从性的影响，发现增加了 ART 使用意向（n=1）、自我报告的依从性（n=1）和病毒抑制（n=1，无对照组）。其他针对 HIV 阳性 MSM 的 mHealth 干预措施侧重于状态披露和降低性风险。
总结：支持 MSM 中 ART 依从性的 mHealth 干预措施具有可接受性、可行性和初步疗效。尽管之前有证据表明（2015 年之前）有效，但最近针对 MSM 的 mHealth 干预措施没有测量对病毒抑制的影响，与对照组相比。正在进行的研究包括旨在改善复杂智能手机或基于互联网平台内依从性的多项功能。未来的发展方向包括克服测量和参与方面的挑战、开发用于协调患者和提供者依从性数据的工具、测试联合干预措施以及为新语言和地理环境改编有效的干预措施。
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