Electronic and other new media technology interventions for HIV care and prevention: a systematic review

Abstract

Introduction Electronic and other new media technologies (eHealth) can facilitate large‐scale dissemination of information and effective delivery of interventions for HIV care and prevention. There is a need to both monitor a rapidly changing pipeline of technology‐based care and prevention methods and to assess whether the interventions are appropriately diversified. We systematically review and critically appraise the research pipeline of eHealth interventions for HIV care and prevention, including published studies and other funded projects. Methods Two peer‐reviewed literature databases were searched for studies describing the development, trial testing or implementation of new technology interventions, published from September 2014 to September 2018. The National Institutes of Health database of grants was searched for interventions still in development. Interventions were included if eHealth was utilized and an outcome directly related to HIV treatment or prevention was targeted. We summarized each intervention including the stage of development, eHealth mode of delivery, target population and stage of the HIV care and prevention continua targeted. Results and discussion Of 2178 articles in the published literature, 113 were included with 84 unique interventions described. The interventions utilize a variety of eHealth technologies and target various points on the prevention and care continua, with greater emphasis on education, behaviour change and testing than linkage to medical care. There were a variety of interventions for HIV care support but none for PrEP care. Most interventions were developed for populations in high income countries. An additional 62 interventions with funding were found in the development pipeline, with greater emphasis on managing HIV and PrEP care. Conclusions Our systematic review found a robust collection of eHealth interventions in the published literature as well as unpublished interventions still in development. In the published literature, there is an imbalance of interventions favouring education and behaviour change over linkage to care, retention in care, and adherence, especially for PrEP. The next generation of interventions already in the pipeline might address these neglected areas of care and prevention, but the development process is slow. Researchers need new methods for more efficient and expedited intervention development so that current and future needs are addressed.

Risk factors for loss to follow‐up among at‐risk HIV negative men who have sex with men participating in a research cohort with access to pre‐exposure prophylaxis in coastal Kenya

“…MSM and male sex workers are often mobile, which may impact LTFU [10,12]. Providing information about LGBTQ‐friendly PrEP‐providing facilities through peers or eHealth support [28], may improve continuity of care when participants move or decide to change clinics.…”

PrEP uptake and adherence in relation to HIV-1 incidence among Kenyan men who have sex with men

“…In Kenya, where same-sex behavior is stigmatized, PrEP-taking individuals may benefit from a peer support model, which recently led to improved ART adherence among MSM in a pilot study in coastal Kenya [36] . In addition, interventions such as eHealth technologies and intensified engagement are needed to support retention of MSM in PrEP care which may improve PrEP adherence over time [37] .…”

‘It's like getting an Uber for sex’: social networking apps as spaces of risk and opportunity in the Philippines among men who have sex with men

“…However, the authors noted that few online interventions had occurred in low-and middle-income countries. Another study assessing the effectiveness of using Grindr to increase HIV self-testing among Black and Latino MSM in Los Angeles found online interventions resulted in more linkage to testing than offline outreach, and a greater likelihood to reach untested high-risk populations (Maloney, Bratcher, Wilkerson, & Sullivan, 2020). Yet, it was found that such interventions were also limited to individual behaviour change by only encouraging testing and education, resulting in an absence of interventions addressing linkage to and retention in care, or adherence.…”