Mao Limin, Buchanan Andrew, Wong Horas Tze Hoo, Persson Asha
Centre for Social Research in Health, UNSW Australia, Sydney, NSW, Australia.
The Bobby Goldsmith Foundation, Sydney, NSW, Australia.
Health Soc Care Community. 2018 Jul;26(4):486-494. doi: 10.1111/hsc.12544. Epub 2018 Jan 15.
SMS reminders sent to personal mobiles are increasingly used by clinical services to promote patient engagement, including adherence to antiretroviral treatment (ART) for HIV. From August to September 2015, a 6-week, randomised SMS reminder for ART adherence intervention was implemented among 98 HIV-positive clients of Australian's largest HIV charitable organisation located in Sydney. This was followed by a mixed-method evaluation, comprising a self-completed online survey and a one-to-one interview. Of the 62 survey participants, all being men, the majority were gay (85.5%) and living long-term with HIV (median year of HIV diagnosis = 1998). While everyone was on ART, a substantial proportion (n = 27, 43.5%) had interrupted treatment in the past. At the end of the intervention, based on the standard SMAQ measure, 82% had consistently adhered to ART in the previous week. While there was no statistically significant intervention effect, perceiving less stigma were independently associated with better ART adherence (adjusted odds ratio = 0.37; 95% CI 0.16-0.89; P = .026). Of the 11 interviewees, despite limited add-on effects on individual ART adherence, the campaign was well-received as a unique community support service. This study underscores the essential role of empowerment through enhancing disease self-management, increasing social support and reducing stigma, particularly for long-term HIV survivors. SMS messaging, part of mHealth, delivered by community services could have broader impacts on reducing health and social inequity.
临床服务机构越来越多地使用发送到个人手机的短信提醒来促进患者参与，包括坚持接受艾滋病毒抗逆转录病毒治疗（ART）。2015年8月至9月，对悉尼一家澳大利亚最大的艾滋病毒慈善组织的98名艾滋病毒呈阳性的客户实施了一项为期6周的随机短信提醒以促进ART依从性的干预措施。随后进行了一项混合方法评估，包括自我完成的在线调查和一对一访谈。在62名参与调查的参与者中，均为男性，大多数是同性恋者（85.5%），长期感染艾滋病毒（艾滋病毒诊断的中位年份 = 1998年）。虽然每个人都在接受ART治疗，但很大一部分人（n = 27，43.5%）过去曾中断过治疗。在干预结束时，根据标准的SMAQ测量方法，82%的人在上一周一直坚持接受ART治疗。虽然没有统计学上显著的干预效果，但较少感受到耻辱感与更好的ART依从性独立相关（调整后的优势比 = 0.37；95%置信区间0.16 - 0.89；P = 0.026）。在11名受访者中，尽管对个人ART依从性的附加效果有限，但该活动作为一项独特的社区支持服务受到了好评。这项研究强调了通过加强疾病自我管理、增加社会支持和减少耻辱感来增强权能的重要作用，特别是对于长期的艾滋病毒幸存者。作为移动健康一部分的短信服务由社区服务提供，可能会对减少健康和社会不平等产生更广泛的影响。
