Mobile health for early retention in HIV care: a qualitative study in Kenya (WelTel Retain)
Open accessAbstract
Many people newly diagnosed with HIV are lost to follow-up before timely initiation of antiretroviral therapy (ART). A randomised controlled trial (RCT), WelTel Kenya1, demonstrated the effectiveness of the WelTel text messaging intervention to improve clinical outcomes among patients initiating ART. In preparation for WelTel Retain, an RCT that will evaluate the effect of the intervention to retain patients in care immediately following HIV diagnosis, we conducted an informative qualitative study with people living with HIV (n = 15) and healthcare providers (HCP) (n = 5) in October 2012. Study objectives included exploring the experiences of people living with HIV who have attempted to engage in HIV care, the use of cell phones in everyday life, and perceptions of communicating via text message with HCP. Participants were recruited through convenience sampling. Semi-structured, qualitative interviews were conducted and recorded, transcribed verbatim and analysed using NVivo software. Analysis was guided by the Theory of Reasoned Action and the Technology Acceptance Model. Results indicate that while individuals have many motivators for engaging in care after diagnosis, structural and individual barriers including poverty, depression and fear of stigma prevent them from doing so. All participants had access to a mobile phone, and most were comfortable communicating through text messages, or were willing to learn. Both people living with HIV and HCP felt that increased communication via the text messaging intervention has the potential to enable early identification of problems, leading to timely problem solving that may improve retention and engagement in care during the first year after diagnosis.
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Most SMS-based interventions are pilot tested (stage 3) or at large scale implementation stage (stage 4).
“most SMS based interventions are pilot tested (stage 3) [31,34,37,38,42,71] or at large scale implementation stage (stage 4) [28 -30,32,35].”
From Current evidence on the use of mHealth approaches in Sub-Saharan Africa: A scoping review (2023) · cites this paper as [38]
The Introduction (page unavailable) describes an SMS intervention and says this qualitative study was conducted to inform a planned WelTel Retain trial. Our copy does not classify the intervention as stage 3 or stage 4, establish that it was pilot tested or implemented at large scale, or assess what stage most SMS interventions have reached. Searched for pilot testing and the stage classifications. (LLM, conf=0.70)
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Research works printed but not linked: 29
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- Authors
- Smillie, K., Borek, N. V., Kop, M. L. V. D., Lukhwaro, A., Li, N., Karanja, S., Patel, A. R., Ojakaa, D., & Lester, R. T.
- Affiliations
- BC Centre for Disease Control (CA)
- McMaster University (CA)
- University of British Columbia (CA)
- Amref Health Africa (KE)
- Université de Montréal (CA)
- Corresponding author
- Lester, Richard T
- Venue
- African Journal of AIDS Research
- Published
- 2014-10-02
- Volume
- 13
- Issue
- 4
- Pages
- 331-338
- ISSN
- 1608-5906 (ISSN-L)
- 1727-9445
- PMC
- PMC5585007
- OpenAlex
- W2020963687
- Cited by
- 62
- References
- 33
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 8 · 2023: 4 · 2022: 1 · 2021: 9 · 2020: 9 · 2019: 7 · 2018: 4 · 2017: 5 · 2016: 4 · 2015: 7
- FWCI
- 9.66
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- African Journal of AIDS Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (R01MH097558)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- mobile health, text messaging, HIV care retention, people living with HIV, antiretroviral therapy initiation, loss to follow-up, HIV stigma, poverty, depression, provider communication, mobile phone use, theory of reasoned action, technology acceptance model
- MeSH terms
- Adult, Communication, Female, Follow-Up Studies, Humans, Kenya, Male, Middle Aged, Patient Compliance, HIV Infections, Telemedicine, Qualitative Research, Young Adult, Text Messaging
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