000078989 001__ 78989
000078989 005__ 20200716101434.0
000078989 0247_ $$2doi$$a10.1371/journal.pone.0215236
000078989 0248_ $$2sideral$$a111475
000078989 037__ $$aART-2019-111475
000078989 041__ $$aeng
000078989 100__ $$aVenables, E.
000078989 245__ $$aPatient and health-care worker experiences of an HIV viral load intervention using SMS: A qualitative study
000078989 260__ $$c2019
000078989 5060_ $$aAccess copy available to the general public$$fUnrestricted
000078989 5203_ $$aBackground: Mobile Health or mHealth interventions, including Short Message Service (SMS), can help increase access to care, enhance the efficiency of health service delivery and improve diagnosis and treatment for HIV. Text messaging, or SMS, allows for the low cost transmission of information, and has been used to send appointment reminders, information about HIV counselling and treatment, messages to encourage adherence and information on nutrition and side-effects. HIV Viral Load (VL) monitoring is recommended by the WHO and has been progressively adopted in many settings. In Zimbabwe, implementation of VL is routine and has been rolled out with support of Médecins Sans Frontières (MSF) since 2012. An SMS intervention to assist with the management of VL results was introduced in two rural districts of Zimbabwe. After completion of the HIV VL testing at the National Microbiology Reference Laboratory in Harare, results were sent to health facilities via SMS. Consenting patients were also sent an SMS informing them that their viral load results were ready for collection at their nearest health facilities. No actual VL results were sent to patients.
Methods: A qualitative study was conducted in seven health-care facilities using in-depth interviews (n = 32) and focus group discussions (n = 5) to explore patient and health-care worker experiences of the SMS intervention. Purposive sampling was used to select participants to ensure that male and female patients, as well as those with differing VL results and who lived differing distances from the clinics were included. Data were transcribed, translated from Shona into English, coded and thematically analysed using NVivo software.
Results: The VL SMS intervention was considered acceptable to patients and health-care workers despite some challenges in implementation. The intervention was perceived by health-care workers as improving adherence and well-being of patients as well as improving the management of VL results at health facilities. However, there were some concerns from participants about the intervention, including challenges in understanding the purpose and language of the messages and patients coming to their health facility unnecessarily. Healthcare workers were more concerned than patients about unintentional HIV disclosure relating to the content of the messages or phone-sharing.
Conclusion: This was an innovative intervention in Zimbabwe, in which SMS was used to send VL results to health-care facilities, and notifications of the availability of VL results to patients. Interventions such as this have the potential to reduce unnecessary clinic visits and ensure patients with high VL results receive timely support, but they need to be properly explained, alongside routine counselling, for patients to fully benefit. The findings of this study also have potential policy implications, as if implemented well, such an SMS intervention has the potential to help patients adopt a more active role in the self-management of their HIV disease, become more aware of the importance of adherence and VL monitoring and seek follow-up at clinics when results are high.
000078989 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000078989 590__ $$a2.74$$b2019
000078989 592__ $$a1.023$$b2019
000078989 591__ $$aMULTIDISCIPLINARY SCIENCES$$b27 / 71 = 0.38$$c2019$$dQ2$$eT2
000078989 593__ $$aMultidisciplinary$$c2019$$dQ1
000078989 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000078989 700__ $$aNdlovu, Z.
000078989 700__ $$aMunyaradzi, D.
000078989 700__ $$0(orcid)0000-0001-6756-9515$$aMartínez-Pérez, G.$$uUniversidad de Zaragoza
000078989 700__ $$aMbofana, E.
000078989 700__ $$aNyika, P.
000078989 700__ $$aChidawanyika, H.
000078989 700__ $$aGarone, D.B.
000078989 700__ $$aBygrave, H.
000078989 7102_ $$11006$$2255$$aUniversidad de Zaragoza$$bDpto. Fisiatría y Enfermería$$cÁrea Enfermería
000078989 773__ $$g14, 4 (2019), e0215236$$pPLoS One$$tPLoS ONE$$x1932-6203
000078989 8564_ $$s529606$$uhttps://zaguan.unizar.es/record/78989/files/texto_completo.pdf$$yVersión publicada
000078989 8564_ $$s98117$$uhttps://zaguan.unizar.es/record/78989/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000078989 909CO $$ooai:zaguan.unizar.es:78989$$particulos$$pdriver
000078989 951__ $$a2020-07-16-08:53:46
000078989 980__ $$aARTICLE