Adhiambo Harriet Fridah, Mwamba Chanda, Lewis-Kulzer Jayne, Iguna Sarah, Ontuga Gladys Moraa, Mangale Dorothy Imbuka, Nyandieka Everlyne, Nyanga James, Opondo Isaya, Osoro Joseph, Montoya Lina, Nyagesoa Edwin, Sang Norton, Akama Eliud, Bukusi Elizabeth, Abuogi Lisa, Geng Elvin, Kwena Zachary Arochi
Research Care Training Program, Centre for Microbiology Research, Kenya Medical Research Institute, Kisumu, Kenya.
Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, United States of America.
PLOS Glob Public Health. 2025 Jan 9;5(1):e0002830. doi: 10.1371/journal.pgph.0002830. eCollection 2025.
Structural, psychological, and clinical barriers to HIV care engagement among adolescents and young adults living with HIV (AYAH) persist globally despite gains in HIV epidemic control. Phone-based peer navigation may provide critical peer support, increase delivery flexibility, and require fewer resources. Prior studies show that phone-based navigation and automated text messaging interventions improve HIV care engagement, adherence, and retention among AYAH. However, little is known about AYAH experiences utilizing electronic phone-based peer navigation and automated text messaging (E-NAV). We assessed the experiences of AYAH receiving phone-based peer navigation to address barriers to HIV care engagement and viral suppression. We purposefully selected participants randomized to E-NAV within the Adapt for Adolescents in Kisumu, Kenya, and conducted 20 in-depth interviews. Interviews were conducted by a trained qualitative researcher between October and December 2021 and explored topics such as health-seeking and care experiences, E-NAV acceptability and benefits, and the client-navigator relationship. The interviews were audio-recorded and transcribed. We then applied inductive and deductive coding, followed by thematic analysis. Overall, participants found E-NAV acceptable in regard to content and frequency-particularly the opportunity to select a preferred time for calls/text messages, including evenings and weekends. They found the tone of navigator calls and messages friendly, supporting relationship building. Further, AYAH-navigator relationships were described as fraternal, client-focused, and confidential, which supported a personal connection and trust. Reported E-NAV benefits included adherence and appointment reminders, increased knowledge about HIV care, and strategies to address HIV stigma. Electronic navigation is a promising method for youth peer navigation because it optimizes reach (both in time and space) for youth that have severe constraints on both while preserving the ability to create a rapport and a relationship with patients.
尽管在控制艾滋病流行方面取得了进展，但全球范围内，感染艾滋病毒的青少年和青年（AYAH）在接受艾滋病毒护理方面仍然存在结构、心理和临床障碍。基于电话的同伴导航可能会提供关键的同伴支持，提高服务灵活性，并需要更少的资源。先前的研究表明，基于电话的导航和自动短信干预可改善AYAH的艾滋病毒护理参与度、依从性和留存率。然而，对于AYAH使用基于电子电话的同伴导航和自动短信（E-NAV）的体验知之甚少。我们评估了接受基于电话的同伴导航以消除艾滋病毒护理参与和病毒抑制障碍的AYAH的体验。我们特意从肯尼亚基苏木的“适应青少年”项目中随机选择了参与E-NAV的参与者，并进行了20次深入访谈。访谈由一名训练有素的定性研究人员在2021年10月至12月期间进行，探讨了诸如寻求医疗和护理体验、E-NAV的可接受性和益处以及客户与导航员的关系等主题。访谈进行了录音和转录。然后我们应用了归纳和演绎编码，随后进行了主题分析。总体而言，参与者认为E-NAV在内容和频率方面是可以接受的，特别是有机会选择包括晚上和周末在内的首选通话/短信时间。他们发现导航员的通话和短信语气友好，有助于建立关系。此外，AYAH与导航员之间关系被描述为兄弟般的、以客户为中心且保密的，这有助于建立个人联系和信任。报告的E-NAV益处包括依从性和预约提醒、增加对艾滋病毒护理的了解以及应对艾滋病毒污名化的策略。电子导航是一种很有前景的青年同伴导航方法，因为它在时间和空间上优化了对那些在这两方面都受到严重限制的青年的覆盖范围，同时保留了与患者建立融洽关系和联系的能力。
