A Rapid Review of eHealth Interventions Addressing the Continuum of HIV Care (2007–2017)

Abstract

National HIV prevention goals call for interventions that address Continuum of HIV Care (CoC) for persons living with HIV. Electronic health (eHealth) can leverage technology to rapidly develop and disseminate such interventions. We conducted a qualitative review to synthesize (a) technology types, (b) CoC outcomes, (c) theoretical frameworks, and (d) behavior change mechanisms. This rapid review of eHealth, HIV-related articles (2007–2017) focused on technology-based interventions that reported CoC-related outcomes. Forty-five studies met inclusion criteria. Mobile texting was the most commonly reported technology (44.4%, k = 20). About 75% (k = 34) of studies showed proven or preliminary efficacy for improving CoC-related outcomes. Most studies (60%, k = 27) focused on medication adherence; 20% (k = 9) measured virologic suppression. Many eHealth interventions with preliminary or proven efficacy relied on mobile technology and integrated knowledge/cognition as behavior change mechanisms. This review identified gaps in development and application of eHealth interventions regarding CoC.

Health Behavior Theory to Enhance eHealth Intervention Research in HIV: Rationale and Review

“…These reviews indicated 23% to 74% of eHealth interventions in HIV were informed by HBT [3,5,12,46]. One review reported that social cognitive theories accounted for half of all theories employed among eHealth interventions for adolescents [12].…”

“…Another review found that IMB was the most common theory employed in eHealth interventions targeting medication adherence [46]. The use of theory was less common among studies in low- and middle-income countries (LMIC;19%) relative to high-income countries (HIC; 48%) [3,23]. The lack of theory-informed eHealth interventions is not unique to the field of HIV prevention and treatment.…”

“…eHealth interventions generally aim to change an individual’s health behavior in some way. For persons living with HIV, eHealth interventions might promote engagement and retention in care [3,4] and self-management of the disease, including medication adherence [3–6]. eHealth prevention interventions for individuals at risk for acquiring HIV often focus on increasing regular testing [7] or reducing drug use [8] and sexual risk behaviors [9,10].…”

A Systematic Review of eHealth Interventions Addressing HIV/STI Prevention Among Men Who Have Sex With Men

“…However, the second study only reviewed eHealth trials in Europe countries [34]. Meanwhile, in recent years, since the fast growth of eHealth interventions in HIV/AIDS prevention and treatment has been observed [28,[36][37][38], it is expected to see an explosive number of eHealth interventions in MSM population, which may be far more than 13 interventions reviewed in the first study [35]. Therefore, it is necessary to update and extend prior reviews to inform the effectiveness of global eHealth interventions among MSM.…”

Implementation of eHealth Interventions Across the HIV Care Cascade: a Review of Recent Research

“…eHealth interventions leveraging these technology platforms can reach patients across the HIV care cascade, offering novel, affordable approaches to increase rates of HIV testing, diagnosis, linkage to care, treatment retention, treatment adherence, and viral suppression [5]. For example, SMS interventions are highly effective at improving antiretroviral therapy (ART) adherence, and recent studies have demonstrated that weekly reminder texts and interactive patient interfaces improve patient adherence by 28% when compared with the standard of care [6].…”