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- Title
Implementation of a Mobile Health Strategy to Improve Linkage to and Engagement with HIV Care for People Living with HIV, Tuberculosis, and Substance Use in Irkutsk, Siberia.
- Authors
Hodges, Jacqueline; Zhdanova, Svetlana; Koshkina, Olga; Suzdalnitsky, Alexey; Waldman, Ava Lena; Schwendinger, Jason; Vitko, Serhiy; Plenskey, Alexey; Plotnikova, Yulia; Moiseeva, Elena; Koshcheyev, Mikhail; Sebekin, Sergey; Ogarkov, Oleg; Dillingham, Rebecca; Heysell, Scott
- Abstract
In Irkutsk, Siberia, there is a high prevalence of HIV and tuberculosis (TB) coinfection. Mobile health (mHealth) strategies have shown promise for increasing linkage to and engagement in care for people living with HIV (PLWH) in other contexts. We evaluated outcomes for a cohort of PLWH, TB, and substance use in Irkutsk after participation in a multi-feature mHealth intervention called MOCT. Sixty patients were enrolled during hospitalization for TB. We evaluated participant app usage, linkage to HIV care postdischarge, perception of self-efficacy related to HIV care, and HIV-related clinical outcomes at 6 months. We also performed an exploratory analysis to compare a subset of 49 patients with a pre-intervention cohort matched for age and gender. Participants demonstrated engagement with app features examined at 6 months. The majority linked to HIV care by 6 months (83%). Self-scoring of confidence in ability to communicate with HIV providers improved from baseline (median score 8, scale 1–10) to 6 months (10, p = 0.004). A higher proportion of the MOCT subset refilled antiretroviral therapy (69% vs. 43% in pre-intervention cohort, p = 0.01), with fewer deaths in the MOCT subset at 6 months (1 death vs. 10 deaths in pre-intervention cohort, p = 0.02) and a decreased likelihood of developing the composite outcome of death/failure to achieve viral suppression at 6 months (adjusted odds ratio = 0.33, p = 0.029). This study demonstrates preliminary intervention uptake and improvement in short-term outcomes for an urban cohort of PLWH, TB, and substance use enrolled in a multi-feature mHealth intervention, a novel strategy for the context. Clinical Trial Registration Number: NCT03819374.
- Subjects
RUSSIA; HIV infection prognosis; HIV infections; HIV-positive persons; RESEARCH; SUBSTANCE abuse; CLINICAL trials; MOBILE apps; ANTIRETROVIRAL agents; CONTINUUM of care; TREATMENT effectiveness; HUMAN services programs; PATIENTS' attitudes; SELF-efficacy; COMPARATIVE studies; PRE-tests &; post-tests; QUALITY assurance; TUBERCULOSIS; DESCRIPTIVE statistics; HOSPITAL care; METROPOLITAN areas; ODDS ratio; TELEMEDICINE; DRUG abusers; LONGITUDINAL method; DISCHARGE planning; EVALUATION
- Publication
AIDS Patient Care & STDs, 2021, Vol 35, Issue 3, p84
- ISSN
1087-2914
- Publication type
Article
- DOI
10.1089/apc.2020.0233