Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 10920 Wilshire Blvd. Suite 350, Los Angeles, CA, 90024, USA.
Department of Health Policy Management, University of California, Los Angeles, CA, USA.
Prev Sci. 2019 Jan;20(1):126-136. doi: 10.1007/s11121-018-0950-1.
Community-based HIV testing and counseling (HTC) programs have become an important part of the healthcare system in South Africa and other low- and middle-income countries with a high HIV prevalence and strained primary healthcare system. Current HTC programs excel at identifying people living with HIV (PLH) but leave gaps in linkage to care and antiretroviral therapy (ART) as most HTC programs do not have the capacity to ensure that linkage has occurred. This article presents the protocol for an mHealth study, that is, pilot testing a mobile platform in KwaZulu-Natal (KZN), South Africa, to improve linkage to care and ART adherence after home-based HTC. Testing data are shared with designated clinics. PLH are identified using fingerprint scans, mobile numbers, or South African IDs. If PLH do not present at a designated clinic after testing HIV positive, study field staff are sent SMS alerts to prompt follow-up visits. Similarly, if PLH do not refill ART prescriptions after their initial 1-month dose runs out, SMS alerts that are sent to field staff. This paper presents the mHealth study protocol and baseline sample characteristics (N = 101 PLH). Analyses will summarize rates of linkage to care and ART prescription refills. Cost-effectiveness analyses will examine the costs and benefits of linkage and ART adherence using our mHealth system. Linkage to care rates will be compared between our study and a historical control, that is, provided by a prior HTC program that was conducted in KZN without our mHealth system (n = 615).
社区为基础的艾滋病毒检测和咨询（HTC）计划已成为南非和其他艾滋病毒高发且初级医疗保健系统紧张的中低收入国家医疗保健系统的重要组成部分。目前的 HTC 计划在发现艾滋病毒感染者（PLHIV）方面表现出色，但在与护理和抗逆转录病毒治疗（ART）的联系方面存在差距，因为大多数 HTC 计划没有能力确保联系已经发生。本文介绍了一项移动健康研究的方案，即在南非夸祖鲁-纳塔尔省（KZN）试点测试一个移动平台，以改善基于家庭的 HTC 后与护理和 ART 依从性的联系。测试数据与指定诊所共享。PLHIV 通过指纹扫描、手机号码或南非身份证识别。如果 PLHIV 在 HIV 检测呈阳性后未到指定诊所就诊，研究现场工作人员将收到短信提醒以进行随访。同样，如果 PLHIV 在初始 1 个月剂量用完后未再开 ART 处方，也会向现场工作人员发送短信提醒。本文介绍了移动健康研究方案和基线样本特征（N=101 名 PLHIV）。分析将总结与护理和 ART 处方续配的联系率。成本效益分析将使用我们的移动健康系统来检查联系和 ART 依从性的成本和效益。将比较我们的研究与历史对照（n=615）之间的联系率，即由 KZN 以前的 HTC 计划提供，该计划没有我们的移动健康系统。
