title: Acceptability and Feasibility of a Mobile Phone-Based Case Management Intervention to Retain Mothers and Infants from an Option B+ Program in Postpartum HIV Care.
abstract: The objective of this study was to assess the acceptability and feasibility of a cell phone based case manager intervention targeting HIV-infected pregnant women on highly-active antiretroviral therapy (HAART). Pregnant women ≥36 weeks gestation attending antenatal care and receiving HAART through the Option B+ program at a primary care clinic in South Africa were enrolled into a prospective pilot intervention to receive text messages and telephone calls from a case manager through 6 weeks postpartum. Acceptability and feasibility of the intervention were assessed along with infant HIV testing rates and 10-week and 12-month postpartum maternal retention in care. Retention outcomes were compared to women of similar eligibility receiving care prior to the intervention. Fifty women were enrolled into the pilot from May to July 2013. Most (70%) were HAART-naive at time of conception and started HAART during antenatal care. During the intervention, the case manager sent 482 text messages and completed 202 telephone calls, for a median of 10 text messages and 4 calls/woman. Ninety-six percent completed the postpartum interview and 47/48 (98%) endorsed the utility of the intervention. Engagement in 10-week postpartum maternal HIV care was >90% in the pre-intervention (n = 50) and intervention (n = 50) periods; by 12-months retention fell to 72% and was the same across periods. More infants received HIV-testing by 10-weeks in the intervention period as compared to pre-intervention (90.0 vs. 63.3%, p < 0.01). Maternal support through a cell phone based case manager approach was highly acceptable among South African HIV infected women on HAART and feasible, warranting further assessment of effectiveness.
authors: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599, USA, sheree_schwartz@med.unc.edu.
authors: Sheree R
authors: SR
authors: Schwartz
authors: Kate
authors: K
authors: Clouse
authors: Nompumelelo
authors: N
authors: Yende
authors: Annelies
authors: A
authors: Van Rie
authors: Jean
authors: J
authors: Bassett
authors: Mamothe
authors: M
authors: Ratshefola
authors: Audrey
authors: A
authors: Pettifor
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D019090:Case Management; D040421:Cell Phone; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000628:therapy* / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D059012:Lost to Follow-Up; D009035:Mothers; D011181:Postnatal Care / Q000379:methods*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000628:therapy*; D011446:Prospective Studies; D012984:Software; D013019:South Africa
references: J Biomed Inform. 2009 Apr;42(2):377-81
references: 18929686
references: AIDS. 2014 Feb 20;28(4):599-601
references: 24469000
references: J Acquir Immune Defic Syndr. 2008 Apr 15;47(5):597-606
references: 18285714
references: J Int AIDS Soc. 2012;15 Suppl 2:17389
references: 22789644
references: J Acquir Immune Defic Syndr. 2011 Sep 1;58(1):115-9
references: 21546845
references: AIDS. 2011 Mar 27;25(6):825-34
references: 21252632
references: BMJ Open. 2013 Dec 17;3(12):e003950
references: 24345901
references: Trop Med Int Health. 2013 Apr;18(4):451-60
references: 23374278
references: J Acquir Immune Defic Syndr. 2010 May 1;54(1):35-41
references: 20216425
references: AIDS. 2014 Feb 20;28(4):589-98
references: 24468999
references: MMWR Morb Mortal Wkly Rep. 2013 Mar 1;62(8):148-51
references: 23446514
references: AIDS. 2005 Mar 4;19(4):423-31
references: 15750396
references: J Acquir Immune Defic Syndr. 2011 Oct 1;58(2):224-8
references: 21709566
references: Psychol Bull. 1992 May;111(3):455-74
references: 1594721