Jiao Kedi, Ma Jing, Lin Yuxi, Li Yijun, Yan Yu, Cheng Chunxiao, Jia Wenwen, Meng Jing, Wang Lina, Cao Yanwen, Zhao Zhonghui, Yang Xuan, Liao Meizhen, Kang Dianmin, Wang Chunmei, Ma Wei
Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Institution for AIDS/STD Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China.
Digit Health. 2024 Jun 4;10:20552076241257447. doi: 10.1177/20552076241257447. eCollection 2024 Jan-Dec.
This study aimed to compare the effectiveness of instant versus text messaging intervention (TMI) on antiretroviral therapy (ART) adherence among men who have sex with men (MSM) living with HIV.
This study was conducted in an infectious disease hospital of Jinan, China from October 2020 to June 2021, using non-randomized concurrent controlled design to compare the effectiveness of instant messaging intervention (IMI) versus TMI. The intervention strategies (health messaging, medication reminder, and peer education) and contents were consistent between the two groups, and the difference was service delivery method and type of information. The primary outcome was the proportion of achieving optimal ART adherence, defined as never missing any doses and delayed any doses more than 1 hour.
A total of 217 participants (including 72 in TMI group and 145 in IMI group) were included in the study. The proportion of achieving optimal adherence was higher in IMI group than TMI group at the first follow-up (90.2% versus 77.6%, = 0.021) and second follow-up (86.5% versus 76.6%, = 0.083). The effect of IMI versus TMI on improving ART adherence was found not to be statistically significant (risk ratio (RR) = 1.93, 95% confidence interval (CI): 0.95-3.94) in complete-case analysis. However, when excluding participants who did not adhere to the interventions, a significant improvement was observed (RR = 2.77, 95%CI: 1.21-6.38). More participants in IMI group expressed highly rated satisfaction to the intervention services than those in TMI group (67.3% versus 50.0%).
The IMI demonstrated superior efficacy over TMI in improving ART adherence and satisfaction with intervention services. It is suggested that future digital health interventions targeting ART adherence should prioritize instant messaging with multimedia information in areas with Internet access.
The study was registered at the Chinese Clinical Trial Register (ChiCTR), with number [ChiCTR2000041282].
本研究旨在比较即时干预与短信干预（TMI）对感染艾滋病毒的男男性行为者（MSM）抗逆转录病毒治疗（ART）依从性的效果。
本研究于2020年10月至2021年6月在中国济南的一家传染病医院进行，采用非随机同期对照设计，比较即时通讯干预（IMI）与TMI的效果。两组的干预策略（健康信息、用药提醒和同伴教育）及内容一致，差异在于服务提供方式和信息类型。主要结局是实现最佳ART依从性的比例，定义为从未漏服任何一剂药物且未延迟服药超过1小时。
本研究共纳入217名参与者（包括TMI组72名和IMI组145名）。在首次随访时，IMI组实现最佳依从性的比例高于TMI组（90.2%对77.6%，P = 0.021），第二次随访时也是如此（86.5%对76.6%，P = 0.083）。在完整病例分析中，发现IMI与TMI对提高ART依从性的效果无统计学意义（风险比（RR）= 1.93，95%置信区间（CI）：0.95 - 3.94）。然而，排除未坚持干预的参与者后，观察到显著改善（RR = 2.77，95%CI：1.21 - 6.38）。与TMI组相比，IMI组更多参与者对干预服务表示高度满意（67.3%对50.0%）。
IMI在提高ART依从性和干预服务满意度方面显示出优于TMI的疗效。建议未来针对ART依从性的数字健康干预应在有互联网接入的地区优先采用带有多媒体信息的即时通讯。
本研究在中国临床试验注册中心（ChiCTR）注册，注册号为[ChiCTR2000041282]。
