Exploring the Patterns of Use and Acceptability of Mobile Phones Among People Living With HIV to Improve Care and Treatment: Cross-Sectional Study in Three Francophone West African Countries.

Phillipe Lepère,Guillaume Kanga,Alexandra M Bitty-Anderson,Boris Tchounga,Armel Poda,Serge Koule,Albert Minga,Alexandra Calmy,Pendadiago Touré,Didier K Ekouevi,Gildas Anago,Eugène Messou,Simon P Boni,Patrick A Coffie,Yélamikan Touré

doi:10.2196/13741

Abstract

BackgroundThe use of mobile technology in health care (mobile health [mHealth]) could be an innovative way to improve health care, especially for increasing retention in HIV care and adherence to treatment. However, there is a scarcity of studies on mHealth among people living with HIV (PLHIV) in West and Central Africa.ObjectiveThe aim of this study was to assess the acceptability of an mHealth intervention among PLHIV in three countries of West Africa.MethodsA cross-sectional study among PLHIV was conducted in 2017 in three francophone West African countries: Côte d’Ivoire, Burkina Faso, and Togo. PLHIV followed in the six preselected HIV treatment and care centers, completed a standardized questionnaire on mobile phone possession, acceptability of mobile phone for HIV care and treatment, preference of mobile phone services, and phone sharing. Descriptive statistics and logistic regression were used to describe variables and assess factors associated with mHealth acceptability.ResultsA total of 1131 PLHIV—643 from Côte d’Ivoire, 239 from Togo, and 249 from Burkina Faso—participated in the study. Median age was 44 years, and 76.1% were women (n=861). Almost all participants owned a mobile phone (n=1107, 97.9%), and 12.6% (n=140) shared phones with a third party. Acceptability of mHealth was 98.8%, with the majority indicating their preference for both phone calls and text messages. Factors associated with mHealth acceptability were having a primary school education or no education (adjusted odds ratio=7.15, 95% CI 5.05-10.12; P<.001) and waiting over one hour before meeting a medical doctor on appointment day (adjusted odds ratio=1.84, 95% CI 1.30-2.62; P=.01).ConclusionsThe use of mHealth in HIV treatment and care is highly acceptable among PLHIV and should be considered a viable tool to allow West and Central African countries to achieve the Joint United Nations Programme on HIV/AIDS 90-90-90 goals.

Highlights

Despite the fact that 51% of people living with HIV globally are female, higher treatment coverage and better adherence to treatment among women have driven more rapid declines in AIDS-related deaths among females: deaths from AIDS-related illnesses were 27% lower among women and girls in 2016 than they were among men and boys
1 Estimates of people living with HIV that inform progress towards 90–90–90 are country-supplied and have not been validated by UNAIDS
2 Estimates of people living with HIV that inform progress towards 90–90–90 are country-supplied and have not been validated by UNAIDS. 3 Data from European Centres for Disease Control and Prevention Continuum of HIV care 2017 progress report

Summary

INTRODUCTION

UNAIDS annually provides revised global, regional and country-specific modelled estimates using the best available epidemiological and programmatic data to track the HIV epidemic. Modelled estimates are required because it is impossible to count the exact number of people living with HIV, people who are newly infected with HIV or people who have died from AIDS-related causes in any country: doing so would require regularly testing every person for HIV and investigating all deaths, which is logistically impossible and ethically problematic. Country teams use UNAIDS-supported software to develop estimates annually. The country teams are primarily comprised of demographers, epidemiologists, monitoring and evaluation specialists and technical partners working under the guidance of the national government’s AIDS or health authority. The UNAIDS Reference Group on Estimates, Modelling and Projections provides technical guidance on the development of the HIV component of the software. The software used to produce the estimates is Spectrum, which is developed by Avenir Health, and the Estimates and Projections Package, which is developed by the East–West Center. The UNAIDS Reference Group on Estimates, Modelling and Projections provides technical guidance on the development of the HIV component of the software.

A BRIEF DESCRIPTION OF METHODS USED BY UNAIDS TO CREATE ESTIMATES

Findings

METHODS