Abstract
BackgroundSouth Africa is home to the world’s largest antiretroviral therapy program but sustaining engagement along the HIV care continuum has proven challenging in the country and throughout the wider region. Population mobility is common in South Africa, but there are important research gaps in describing this mobility and its impact on engagement in HIV care. Postpartum women and their infants in South Africa are known to be at high risk of dropping out of HIV care after delivery and are frequently mobile.MethodsIn 2017, we developed a beta version of a smartphone application (app) - CareConekta - that detects a user’s smartphone location to allow for prospective characterization of mobility. Now we will adapt and test CareConekta to conduct essential formative work on mobility and evaluate an intervention - the CareConekta app plus text notifications and phone calls and/or WhatsApp messages - to facilitate engagement in HIV care during times of mobility. During the 3-year project period, our first objective is to evaluate the feasibility, acceptability, and initial efficacy of using CareConekta as an intervention to improve engagement in HIV care. Our second objective is to characterize mobility among South African women during the peripartum period and its impact on engagement in HIV care. We will enroll 200 eligible pregnant women living with HIV and receiving care at the Gugulethu Midwife Obstetric Unit in Cape Town, South Africa.DiscussionThis work will provide critical information about mobility during the peripartum period and the impact on engagement in HIV care. Simultaneously, we will pilot test an intervention to improve engagement with rigorously assessed outcomes. If successful, CareConekta offers tremendous potential as a research and service tool that can be adapted and evaluated in multiple geographic regions, study contexts, and patient populations.Trial registrationClinicalTrials.gov: NCT03836625. Registered on 8 February 2019.
Highlights
Background and rationale {6a} With more than 7 million Human immunodeficiency virus (HIV)-infected people [1], South Africa is home to more people living with HIV than any other country in the world [2], and their national antiretroviral therapy (ART) program is the world’s largest [2]
Eligibility criteria {10} Eligible subjects are adult (≥ 18 years) women living with HIV who are in the third trimester of pregnancy (≥ 28 weeks gestation) and are willing to be randomized
If we conservatively estimate that 30% of all pregnant, HIV-positive women seeking antenatal care each month will be eligible and interested, this equals 30 participants enrolled per month
Summary
Background and rationale {6a} With more than 7 million HIV-infected people [1], South Africa is home to more people living with HIV than any other country in the world [2], and their national antiretroviral therapy (ART) program is the world’s largest [2]. South Africa is home to the world’s largest antiretroviral therapy program but sustaining engagement along the HIV care continuum has proven challenging in the country and throughout the wider region. Population mobility is common in South Africa, but there are important research gaps in describing this mobility and its impact on engagement in HIV care. Postpartum women and their infants in South Africa are known to be at high risk of dropping out of HIV care after delivery and are frequently mobile
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
