Department of Epidemiology, Emory University, Atlanta, GA, USA.
Department of Epidemiology, University of California, Los Angeles, CA, USA.
J Int AIDS Soc. 2020 Jan;23(1):e25439. doi: 10.1002/jia2.25439.
INTRODUCTION: Electronic and other new media technologies (eHealth) can facilitate large-scale dissemination of information and effective delivery of interventions for HIV care and prevention. There is a need to both monitor a rapidly changing pipeline of technology-based care and prevention methods and to assess whether the interventions are appropriately diversified. We systematically review and critically appraise the research pipeline of eHealth interventions for HIV care and prevention, including published studies and other funded projects. METHODS: Two peer-reviewed literature databases were searched for studies describing the development, trial testing or implementation of new technology interventions, published from September 2014 to September 2018. The National Institutes of Health database of grants was searched for interventions still in development. Interventions were included if eHealth was utilized and an outcome directly related to HIV treatment or prevention was targeted. We summarized each intervention including the stage of development, eHealth mode of delivery, target population and stage of the HIV care and prevention continua targeted. RESULTS AND DISCUSSION: Of 2178 articles in the published literature, 113 were included with 84 unique interventions described. The interventions utilize a variety of eHealth technologies and target various points on the prevention and care continua, with greater emphasis on education, behaviour change and testing than linkage to medical care. There were a variety of interventions for HIV care support but none for PrEP care. Most interventions were developed for populations in high income countries. An additional 62 interventions with funding were found in the development pipeline, with greater emphasis on managing HIV and PrEP care. CONCLUSIONS: Our systematic review found a robust collection of eHealth interventions in the published literature as well as unpublished interventions still in development. In the published literature, there is an imbalance of interventions favouring education and behaviour change over linkage to care, retention in care, and adherence, especially for PrEP. The next generation of interventions already in the pipeline might address these neglected areas of care and prevention, but the development process is slow. Researchers need new methods for more efficient and expedited intervention development so that current and future needs are addressed.
简介:电子和其他新媒体技术(eHealth)可以促进信息的大规模传播,并有效地提供艾滋病毒护理和预防干预措施。我们不仅需要监测基于技术的护理和预防方法的快速变化的管道,还需要评估干预措施是否得到适当的多样化。我们系统地审查和批判性评估了 eHealth 干预措施在艾滋病毒护理和预防方面的研究管道,包括已发表的研究和其他资助项目。
方法:我们在两个同行评议的文献数据库中搜索了描述新技术干预措施开发、试验测试或实施的研究,这些研究的发表时间为 2014 年 9 月至 2018 年 9 月。我们还在国立卫生研究院的资助项目数据库中搜索了仍在开发中的干预措施。如果使用了电子卫生技术,并且针对的是与艾滋病毒治疗或预防直接相关的结果,则纳入干预措施。我们总结了每个干预措施,包括开发阶段、电子卫生的交付模式、目标人群以及艾滋病毒护理和预防连续体的目标阶段。
结果和讨论:在已发表的文献中,有 2178 篇文章,其中包括 113 篇,描述了 84 个独特的干预措施。这些干预措施利用了各种电子卫生技术,针对预防和护理连续体的各个点,重点是教育、行为改变和检测,而不是与医疗保健的联系。有各种各样的干预措施用于艾滋病毒护理支持,但没有用于 PrEP 护理的干预措施。大多数干预措施是为高收入国家的人群开发的。在开发管道中还发现了另外 62 个有资金的干预措施,重点是管理艾滋病毒和 PrEP 护理。
结论:我们的系统综述发现,在已发表的文献中以及在未发表的仍在开发中的文献中,有大量的电子卫生干预措施。在已发表的文献中,干预措施存在不平衡,偏向于教育和行为改变,而不是与护理、保留在护理中以及坚持治疗的联系,特别是对于 PrEP。管道中已经有下一代干预措施,可能会解决这些被忽视的护理和预防领域,但开发过程缓慢。研究人员需要新的方法来更有效地开发干预措施,以满足当前和未来的需求。
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