mHealth and opportunities in anti-retroviral adherence in HIV, a diverse group of patients with diverse and unique opportunities: A narrative review

BACKGROUND: Antiretrovirals (ARVs) are key in the management of human immunodeficiency virus (HIV). While no cure exists, ARVs help patients live healthy lives and prevent transmission to others. However, adherence to sometimes complex regiments is paramount to outcomes and in avoiding the emergence of drug-resistant virus. The goal of therapy is to reach an undetectable viral load. However, adherence is a common problem, stemming from such issues as mental health, chaotic home situations and busy work schedules. mHealth represents a new approach to improve medication adherence and multiple studies have been performed in this area. OBJECTIVE: Our paper reviews the current implementations of mHealth in the management of HIV within different groups of patients. METHODS: We used the PubMed, Academic Search Elite, and one journal database with various search terms to review the current implementations of mHealth in HIV care. RESULTS: Results and Discussion: Titles and abstracts were screened and 61 articles were identified then fully reviewed. Literature was divided into lower and higher income nations as defined by the United Nations. 20 studies with quantitative results were identified with 10 being text/SMS based interventions (the majority of these being in lower income countries) and 8 being smartphone-based applications (primarily in higher income countries). The majority of these studies determined whether there was an effect on adherence or biochemical parameters (viral load and CD4 count). Various qualitative studies were also done, and many focused on determining the specific design of interventions that were successful (frequency of messaging, types of messages, etc.) as well as priorities for patients in regards to mHealth interventions. CONCLUSIONS: There seems to be a role in lower income nations; however, the optimal design of an intervention needs to be delineated. In higher income countries where two significant risk factors were injection drugs and MSM, the benefit was less clear and more research is needed

• Population(s)
  • Men who have sex with men
  • People who use drugs
  • Heterosexual men
  • General HIV+ population
• Engagement and Care Cascade
  • Treatment
• Prevention
  • Drug use behaviours/harm reduction
  • Biomedical interventions
  • Education/media campaigns