Online Program

Feasibility of using cell phones to improve treatment adherence among HIV positive women in India – a pilot study

Wednesday, November 6, 2013

Mona Duggal, MD, MHS, Medicine, Yale University, West Haven,, CT
Prabha S. Chandra, MD, Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
Mohini Ranganathan, MD, Psychiatry, Yale University, West Haven, CT
Veena Satyanarayana, PHD, Department of Clinical Psychology, National Institute of Mental Health and Neurosciences,Bangalore,India, Bangalore, India
Nancy R. Reynolds, R.N, Ph.D., F.A.A.N, Nursing, Yale School of Nursing,Director , Doctoral Program, New Haven, CT
Objectives: Recent studies support technology-based interventions for improving adherence to antiretroviral therapy (ART). This pilot study was conducted to assess acceptance of cell phone contact by nurses for addressing adherence issues among HIV+ women in India. The study is part of a larger project aimed at adapting a successful, theory-guided adherence phone intervention developed in the U.S. to the context of HIV+ women in India. Methods: A convenience sample of limited resource, HIV+ women (n=16) were recruited from a government-sponsored ART clinic in Bangalore. Exploratory data was gathered in individual interviews using a semi-structured, study-specific questionnaire. Data were transcribed verbatim and systematically analyzed by the investigators using descriptive and inductive techniques. Results: 70% women had no formal or primary education. Most of the women had disclosed their HIV status to family members and did not report privacy concerns about receiving a call from a nurse. All women had access to cell phones, however, only 3 of 16 had a personal phone. 14 of 16 women indicated that they would like to receive reminders and treatment advice from an HIV nurse specialist by phone. In contrast, only 25% said that they would like to receive automated messages/reminders on the cell phone. The majority cited low literacy as a problem in receiving text messages. Conclusion: HIV+ women in Bangalore find it acceptable to receive treatment related messages and reminders by cell phone. This might be a cheap and effective method for enhancing adherence and support in low resource settings such as India.

Learning Areas:

Assessment of individual and community needs for health education
Communication and informatics
Public health or related nursing
Social and behavioral sciences

Learning Objectives:
Design the development and implementation of the bigger pilot randomized controlled trial, and further qualitative research , including the integrity of the underlying behavior change theory, allowing for improvements on the basis of feedback of target audience in the initial development stages, and a focus on implementation from the start.

Keyword(s): Women and HIV/AIDS, Communication Technology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal investigator of multiple federally funded grants focusing on the HIV health behaviors, antiretroviral medication adherence, mobile phone-facilitated interventions, stigma and disclosure. Among my scientific interests has been the development of strategies for improving HIV and mental health outcomes of vulnerable populations in LMICs (e.g., Ghana and India).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.