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Enhancing engagement in HIV care among adolescents and young adults: A focus on phone-based navigation and relationship building to address barriers in HIV care.

作者信息

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

机构信息

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.

出版信息

PLOS Glob Public Health. 2025 Jan 9;5(1):e0002830. doi: 10.1371/journal.pgph.0002830. eCollection 2025.


DOI:10.1371/journal.pgph.0002830
PMID:39787184
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11717212/
Abstract

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.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/086b/11717212/9b5d0bd31fb7/pgph.0002830.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/086b/11717212/9b5d0bd31fb7/pgph.0002830.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/086b/11717212/9b5d0bd31fb7/pgph.0002830.g001.jpg

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引用本文的文献

[1]
Time-dependent predictors of loss to follow-up in HIV care in low-resource settings: A competing risks approach.

PLoS One. 2025-7-24

[2]
"I-We-I": Visualizing Adolescents' Perceptions and Apprehension to Transition to Adult HIV Care at a Supportive Transition Facility in the Cape Town Metropole, South Africa.

Trop Med Infect Dis. 2025-5-6

本文引用的文献

[1]
The Acceptability, Engagement, and Feasibility of Mental Health Apps for Marginalized and Underserved Young People: Systematic Review and Qualitative Study.

J Med Internet Res. 2024-7-30

[2]
Adaptive Strategies for Retention in Care among Persons Living with HIV.

NEJM Evid. 2023-4

[3]
A youth-centred approach to improving engagement in HIV services: human-centred design methods and outcomes in a research trial in Kisumu County, Kenya.

BMJ Glob Health. 2023-11-29

[4]
HIV Infection Among Adolescents Residing in Urban Informal Settlements of Kenya.

AIDS Educ Prev. 2023-6

[5]
Barriers to linkage and retention in HIV care still persist among adolescent girls and young women in western Kenya.

Afr J AIDS Res. 2023-7

[6]
Barriers and facilitators to anti-retroviral therapy adherence among adolescents aged 10 to 19 years living with HIV in sub-Saharan Africa: A mixed-methods systematic review and meta-analysis.

PLoS One. 2023

[7]
Adapt for Adolescents: Protocol for a sequential multiple assignment randomized trial to improve retention and viral suppression among adolescents and young adults living with HIV in Kenya.

Contemp Clin Trials. 2023-4

[8]
Effectiveness, Acceptability and Feasibility of Technology-Enabled Health Interventions for Adolescents Living with HIV in Low- and Middle-Income Countries: A Systematic Review.

Int J Environ Res Public Health. 2023-1-30

[9]
Differential Effects of Patient Navigation across Latent Profiles of Barriers to Care among People Living with HIV and Comorbid Conditions.

J Clin Med. 2022-12-23

[10]
Adolescent and young adult preferences for financial incentives to support adherence to antiretroviral therapy in Kenya: a mixed methods study.

J Int AIDS Soc. 2022-9

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