Long term impact of PositiveLinks: Clinic-deployed mobile technology to improve engagement with HIV care


Autoři: Chelsea E. Canan aff001;  Marika E. Waselewski aff001;  Ava Lena D. Waldman aff001;  George Reynolds aff002;  Tabor E. Flickinger aff001;  Wendy F. Cohn aff003;  Karen Ingersoll aff004;  Rebecca Dillingham aff001
Působiště autorů: Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States of America aff001;  Health Decision Technologies, Oakland, CA, United States of America aff002;  Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States of America aff003;  Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States of America aff004
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226870

Souhrn

Background

PositiveLinks (PL) is a smartphone-based platform designed in partnership with people living with HIV (PLWH) to improve engagement in care. PL provides daily medication reminders, check-ins about mood and stress, educational resources, a community message board, and an ability to message providers. The objective of this study was to evaluate the impact of up to 24 months of PL use on HIV viral suppression and engagement in care and to examine whether greater PL use was associated with improved outcomes.

Setting

This study occurred between September 2013 and March 2017 at a university-based Ryan White HIV clinic.

Methods

We assessed engagement in care and viral suppression from study baseline to the 6-, 12-, 18- and 24-month follow-up time periods and compared trends among high vs. low PL users. We compared time to viral suppression, proportion of days virally suppressed, and time to engagement in care in patients with high vs. low PL use.

Results

127 patients enrolled in PL. Engagement in care and viral suppression improved significantly after 6 months of PL use and remained significantly improved after 24 months. Patients with high PL use were 2.09 (95% CI 0.64–6.88) times more likely to achieve viral suppression and 1.52 (95% CI 0.89–2.57) times more likely to become engaged in care compared to those with low PL use.

Conclusion

Mobile technology, such as PL, can improve engagement in care and clinical outcomes for PLWH. This study demonstrates long-term acceptability of PL over two years and provides evidence for long-term improvement in engagement in care and viral suppression associated with PL use.

Klíčová slova:

Health insurance – HIV – HIV diagnosis and management – HIV epidemiology – HIV prevention – Medical education – Schools – Viral load


Zdroje

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