The Albion Centre, South Eastern Sydney Local Health District, 150-154 Albion Street, Sydney, NSW, 2010, Australia.
Centre for Social Research in Health, UNSW, Sydney, NSW, 2052, Australia.
BMC Infect Dis. 2018 Feb 17;18(1):82. doi: 10.1186/s12879-018-2972-5.
BACKGROUND: The exponential growth in the reach and development of new technologies over the past decade means that mobile technologies and social media play an increasingly important role in service delivery models to maximise HIV testing and access to treatment and care. This systematic review examines the impact of electronic and mobile technologies in medical care (eHealth) in the linkage to and retention of priority populations in the HIV treatment and care cascade, focussing on the Asia-Pacific region. METHODS: The review was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement from the Cochrane Collaboration guidelines. Both grey and published scientific literature from five different databases were searched for all original articles in English published from 2010 to 2017. Studies conducted outside the Asia-Pacific region or not including HIV priority populations were excluded. The methodological quality of studies included in the review was assessed using the Quality Assessment Tool for Quantitative Studies. RESULTS: The database search identified 7309 records. Of the 224 peer-reviewed articles identified for full text review, 16 studies from seven countries met inclusion criteria. Six cross sectional studies found evidence to support the use of eHealth, via text messages, instant messaging, social media and health promotion websites, to increase rates of HIV testing and re-testing among men who have sex with men (MSM). Evidence regarding the efficacy of eHealth interventions to improve antiretroviral treatment (ART) adherence was mixed, where one randomised controlled trial (RCT) showed significant benefit of weekly phone call reminders on improving ART adherence. Three further RCTs found that biofeedback eHealth interventions that provided estimated ART plasma concentration levels, showed promising results for ART adherence. CONCLUSIONS: This review found encouraging evidence about how eHealth can be used across the HIV treatment and care cascade in the Asia-Pacific region, including increasing HIV testing and re-testing in priority populations as well as ART adherence. eHealth interventions have an important role to play in the movement towards the end of AIDS, particularly to target harder-to-reach HIV priority populations, such as MSM.
背景:过去十年,新技术的应用和发展呈指数级增长,这意味着移动技术和社交媒体在服务提供模式中发挥着越来越重要的作用,以最大限度地提高艾滋病毒检测率,并为治疗和护理提供便利。本系统评价审查了电子和移动技术在医疗保健(电子健康)中的作用,重点关注亚太地区,以评估其在艾滋病毒治疗和护理服务提供中的衔接和保留优先人群方面的影响。
方法:本评价依据 Cochrane 协作组织指南的系统评价和荟萃分析的首选报告项目(PRISMA)声明。从五个不同的数据库中搜索了所有 2010 年至 2017 年期间以英文发表的原始文章的灰色和已发表的科学文献。排除了不在亚太地区开展或不包括艾滋病毒优先人群的研究。使用定量研究质量评估工具评估纳入研究的方法学质量。
结果:数据库检索共确定了 7309 条记录。在对 224 篇同行评审文章进行全文审查后,来自七个国家的 16 项研究符合纳入标准。六项横断面研究发现有证据支持使用电子健康,通过短信、即时消息、社交媒体和健康促进网站,增加男男性行为者(MSM)的艾滋病毒检测和重新检测率。电子健康干预措施提高抗逆转录病毒治疗(ART)依从性的疗效证据不一,一项随机对照试验(RCT)显示,每周电话提醒对改善 ART 依从性有显著益处。另外三项 RCT 发现,提供估计的 ART 血浆浓度水平的生物反馈电子健康干预措施,对 ART 依从性显示出有希望的结果。
结论:本评价发现了令人鼓舞的证据,表明电子健康可在亚太地区艾滋病毒治疗和护理服务提供的各个环节中使用,包括增加优先人群的艾滋病毒检测和重新检测,以及提高抗逆转录病毒治疗的依从性。电子健康干预措施在迈向终结艾滋病的运动中发挥着重要作用,特别是针对更难接触到的艾滋病毒优先人群,如 MSM。
Cochrane Database Syst Rev. 2006-7-19
Cochrane Database Syst Rev. 2018-9-19
Cochrane Database Syst Rev. 2004
Health Technol Assess. 2001
Cochrane Database Syst Rev. 2004-10-18
Curr HIV/AIDS Rep. 2023-12
Pilot Feasibility Stud. 2022-3-11
Online J Public Health Inform. 2021-12-24
J Int AIDS Soc. 2017-3-13
J Int AIDS Soc. 2016-10-18
Bull World Health Organ. 2016-3-1
J Med Internet Res. 2015-11-2