Johannesburg Business School, University of Johannesburg, Johannesburg, South Africa.
Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
BMC Health Serv Res. 2024 Sep 17;24(1):1084. doi: 10.1186/s12913-024-11466-2.
Digital health interventions have the potential to improve linkage to care after HIV self-testing (HIVST). This study aimed to understand clients' and providers' perceptions of benefits, and barriers of a digital health intervention designed to improve linkage to care after HIV self-testing in Tanzania.
This exploratory qualitative research study was conducted in Hai and Moshi, districts in Kilimanjaro region, Tanzania. Four health facilities were selected based on their involvement in an HIVST pilot program implemented by Elizabeth Glassier Pediatric AIDS Foundation (EGPAF) Tanzania through the USAID funded program. The study included female index clients and their partners, and healthcare providers at the healthcare facilities. We used a semi-structured interview guide with open-ended questions for data collection. Data collection was conducted from 16th January 2023 to 3rd February 2023. Thematic analysis of the qualitative data was conducted, guided by the Health Belief Model (HBM), and results were developed in collaboration with the community partners.
A total of 42 participants were included in the study, comprising 9 male clients, 17 female index clients, and 16 health care workers (HCWs) (4 male and 12 female) who were involved in delivering HIVST services. The study's findings revealed mixed feelings about the use of a digital health intervention. Majority of participants perceived digital health as a valuable intervention for enhancing linkage to care, improved health outcomes, improved communication with healthcare workers, and increased privacy. Therefore, they supported scale-up of a digital health intervention. Participants also expressed that the potential benefits of a digital health intervention include the convenience of accessing healthcare services from the comfort of their homes or any location. However, a few participants expressed concerns about potential risks associated with sending health-related text messages. They feared that recipients might not be in a safe space, leading to stigma and avoidance of engagement. A few female participants expressed concerns about confidentiality breaches, particularly regarding shared phones with family or friends. Fear of being judged or misunderstood by others could deter them from reading or acting upon these messages. Most participants recommended tailored strategies that prioritize confidentiality and trust. Recognizing these psychological aspects is vital for customizing digital health interventions to effectively address participants' concerns.
Digital health interventions may improve the linkage of HIV self-testers to care. Recommendations include personalized and culturally relevant communication and technical accessibility to make interventions effective and inclusive. This study provides valuable insights for designing patient-centered interventions for HIV care and treatment.
数字健康干预措施有可能改善艾滋病毒自检（HIVST）后的护理衔接。本研究旨在了解坦桑尼亚数字健康干预措施的利益相关者和提供者对改善 HIVST 后护理衔接的看法，该措施旨在改善艾滋病毒自检后的护理衔接。
本探索性定性研究在坦桑尼亚乞力马扎罗地区的 Hai 和 Moshi 区进行。根据他们参与由伊丽莎白·格拉斯尔儿科艾滋病基金会（EGPAF）坦桑尼亚通过美国国际开发署资助的项目实施的 HIVST 试点计划的情况，选择了四个卫生设施。该研究包括女性索引客户及其伴侣以及卫生保健设施的卫生保健提供者。我们使用带有开放式问题的半结构化访谈指南进行数据收集。数据收集于 2023 年 1 月 16 日至 2 月 3 日进行。对定性数据进行主题分析，以健康信念模型（HBM）为指导，结果与社区合作伙伴共同制定。
共有 42 名参与者参与了研究，包括 9 名男性客户、17 名女性索引客户和 16 名卫生保健工作者（4 名男性和 12 名女性），他们参与提供 HIVST 服务。研究结果表明，对数字健康干预措施的使用存在复杂的看法。大多数参与者认为数字健康是一种有价值的干预措施，可以改善护理衔接、改善健康结果、改善与卫生保健工作者的沟通以及增加隐私。因此，他们支持扩大数字健康干预措施的规模。参与者还表示，数字健康干预措施的潜在好处包括从舒适的家中或任何地点方便地获得医疗服务。然而，一些参与者对与发送与健康相关的短信相关的潜在风险表示担忧。他们担心接收者可能不在安全的环境中，从而导致耻辱感和回避参与。一些女性参与者对保密性违规表示担忧，特别是涉及与家人或朋友共用手机的情况。担心被他人评判或误解可能会阻止他们阅读或采取这些措施。大多数参与者建议采取个性化和文化相关的沟通策略，并优先考虑保密性和信任。认识到这些心理方面对于定制数字健康干预措施以有效解决参与者的担忧至关重要。
数字健康干预措施可能会改善艾滋病毒自检者的护理衔接。建议包括个性化和文化相关的沟通以及技术可及性，以使干预措施有效且具有包容性。本研究为设计以患者为中心的艾滋病毒护理和治疗干预措施提供了有价值的见解。
