Virtual Intervention to Support Self-Management of Antiretroviral Therapy among Persons Living with HIV
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Abstract
Background
Living with HIV necessitates long-term healthcare follow-up particularly with respect to management of antiretroviral therapy (ART). With the enormous possibilities afforded by information and communication technologies (ICT), we developed a virtual nursing intervention (VIH-TAVIEâ„¢) to empower persons living with HIV (PLHIV) to manage their ART and their symptoms optimally. ICT interventions hold great promise across the entire continuum of PLHIV care but further research is needed to properly evaluate their effectiveness.
Objective
The objective of the study was to compare the effectiveness of two types of follow-up–traditional and virtual–in terms of promoting adherence to ART among PLHIV.
Methods
A quasi-experimental study was conducted. A sample of 179 PLHIV on ART for at least six months was recruited, of which 99 at a site offering the virtual follow-up and 80 at another site offering more traditional follow-ups. Adherence, the primary outcome, and cognitive and affective variables (self-efficacy, attitude towards medication intake, symptom-related discomfort, stress or social support) were evaluated by self-administered questionnaire at three measurement times: baseline (T0), and three months (T3) and six months (T6) later.
Results
On average, participants had been living with HIV for 14 years and had been on treatment for 11 years. The groups were highly heterogeneous, but differed on a number of sociodemographic dimensions: education, income, marital status, employment status, and living arrangements. Adherence at baseline was high, reaching 79.7% for the traditional follow-up group and 83.5% for the virtual follow-up group. A generalized estimating equations (GEE) analysis was run, controlling for sociodemographic characteristics at baseline. A time effect was detected, indicating that the two groups improved on adherence over time but did not differ. Improvement at six months was significantly greater than at three months for both groups. Analysis of variance revealed no significant group-by-time interaction on self-efficacy, attitude towards medication intake, symptom-related discomfort, stress or social support. A time effect was observed for both types of follow-up on symptom-related discomfort and social support. Both groups improved over time with respect to these variables.
Conclusions
Results showed that the two groups improved their adherence at six months but did not differ in this regard. Hence, neither type of follow-up proved better than the other in terms of treatment adherence promotion.
Living with HIV necessitates long-term healthcare follow-up particularly with respect to management of antiretroviral therapy (ART). With the enormous possibilities afforded by information and communication technologies (ICT), we developed a virtual nursing intervention (VIH-TAVIEâ„¢) to empower persons living with HIV (PLHIV) to manage their ART and their symptoms optimally. ICT interventions hold great promise across the entire continuum of PLHIV care but further research is needed to properly evaluate their effectiveness.
Objective
The objective of the study was to compare the effectiveness of two types of follow-up–traditional and virtual–in terms of promoting adherence to ART among PLHIV.
Methods
A quasi-experimental study was conducted. A sample of 179 PLHIV on ART for at least six months was recruited, of which 99 at a site offering the virtual follow-up and 80 at another site offering more traditional follow-ups. Adherence, the primary outcome, and cognitive and affective variables (self-efficacy, attitude towards medication intake, symptom-related discomfort, stress or social support) were evaluated by self-administered questionnaire at three measurement times: baseline (T0), and three months (T3) and six months (T6) later.
Results
On average, participants had been living with HIV for 14 years and had been on treatment for 11 years. The groups were highly heterogeneous, but differed on a number of sociodemographic dimensions: education, income, marital status, employment status, and living arrangements. Adherence at baseline was high, reaching 79.7% for the traditional follow-up group and 83.5% for the virtual follow-up group. A generalized estimating equations (GEE) analysis was run, controlling for sociodemographic characteristics at baseline. A time effect was detected, indicating that the two groups improved on adherence over time but did not differ. Improvement at six months was significantly greater than at three months for both groups. Analysis of variance revealed no significant group-by-time interaction on self-efficacy, attitude towards medication intake, symptom-related discomfort, stress or social support. A time effect was observed for both types of follow-up on symptom-related discomfort and social support. Both groups improved over time with respect to these variables.
Conclusions
Results showed that the two groups improved their adherence at six months but did not differ in this regard. Hence, neither type of follow-up proved better than the other in terms of treatment adherence promotion.
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