Skip to main content

Advertisement

SpringerLink
Log in

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

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. World Health Organization (2013). UNAIDS report on the global AIDS epidemic.

  2. Malawi Ministry of Health (2011). Clinical management of HIV in children and adults.

  3. World Health Organization (2013). Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: Recommendations for a public health approach.

  4. Ryan C (2013). The critical role of high impact interventions in achieving an AIDS-free generation. In International conference on AIDS and STIs in Africa. Oral presentation.

  5. Hoffman, R. M., Black, V., Technau, K., et al. (2010). Effects of highly active antiretroviral therapy duration and regimen on risk for mother-to-child transmission of HIV in Johannesburg, South Africa. Journal of Acquired Immune Deficiency Syndromes, 54(1), 35–41. doi:10.1097/QAI.0b013e3181cf9979.

    CAS  PubMed Central  PubMed  Google Scholar 

  6. Chibwesha, C. J., Giganti, M. J., Putta, N., et al. (2011). Optimal time on HAART for prevention of mother-to-child transmission of HIV. Journal of Acquired Immune Deficiency Syndromes, 58(2), 224–228. doi:10.1097/QAI.0b013e318229147e.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Clouse, K., Pettifor, A., Shearer, K., et al. (2013). Loss to follow-up before and after delivery among women testing HIV positive during pregnancy in Johannesburg, South Africa. Tropical medicine & international health: TM & IH, 18(4), 451–460. doi:10.1111/tmi.12072.

    Article  Google Scholar 

  8. Centers for Disease Control and Prevention. (2013). Impact of an innovative approach to prevent mother-to-child transmission of HIV–Malawi, July 2011–September 2012. MMWR Morbidity and Mortality Weekly Report, 62(8), 148–151.

    Google Scholar 

  9. Tenthani, L., Haas, A. D., Tweya, H., et al. (2014). Retention in care under universal antiretroviral therapy for HIV-infected pregnant and breastfeeding women (‘Option B+’) in Malawi. AIDS, 28(4), 589–598. doi:10.1097/QAD.0000000000000143.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Shaffer, N., Abrams, E. J., & Becquet, R. (2014). Option B+ for prevention of mother-to-child transmission of HIV in resource-constrained settings: great promise but some early caution. AIDS, 28(4), 599–601. doi:10.1097/QAD.0000000000000144.

    Article  PubMed  Google Scholar 

  11. Craw, J. A., Gardner, L. I., Marks, G., et al. (2008). Brief strengths-based case management promotes entry into HIV medical care: results of the antiretroviral treatment access study-II. Journal of Acquired Immune Deficiency Syndromes, 47(5), 597–606. doi:10.1097/QAI.0b013e3181684c51.

    Article  CAS  PubMed  Google Scholar 

  12. Gardner, L. I., Metsch, L. R., Anderson-Mahoney, P., et al. (2005). Efficacy of a brief case management intervention to link recently diagnosed HIV-infected persons to care. AIDS., 19(4), 423–431.

    Article  PubMed  Google Scholar 

  13. Kim, M. H., Ahmed, S., Buck, W. C., et al. (2012). The Tingathe programme: a pilot intervention using community health workers to create a continuum of care in the prevention of mother to child transmission of HIV (PMTCT) cascade of services in Malawi. Journal of the International AIDS Society., 15(Suppl 2), 17389. doi:10.7448/IAS.15.4.17389.

    PubMed Central  PubMed  Google Scholar 

  14. Mbuagbaw, L., van der Kop, M. L., Lester, R. T., et al. (2013). Mobile phone text messages for improving adherence to antiretroviral therapy (ART): an individual patient data meta-analysis of randomised trials. BMJ Open, 3(12), e003950. doi:10.1136/bmjopen-2013-003950.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Pop-Eleches, C., Thirumurthy, H., Habyarimana, J. P., et al. (2011). Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. AIDS, 25(6), 825–834. doi:10.1097/QAD.0b013e32834380c1.

    Article  PubMed Central  PubMed  Google Scholar 

  16. South African Audience Research Foundation. Cell Phone Trends. http://www.saarf.co.za/amps/cellphone.asp. Accessed 30 Jan 2014.

  17. Republic of South Africa Department of Health (2012). The 2011 National Antenatal Sentinel HIV & Syphilis Prevalence Survey in South Africa.

  18. Republic of South Africa Department of Health (2013). The South African Antiretroviral Treatment Guidelines: PMTCT Guidelines Revised March 2013.

  19. Fisher, J. D., & Fisher, W. A. (1992). Changing AIDS-risk behavior. Psychological Bulletin, 111(3), 455–474.

    Article  CAS  PubMed  Google Scholar 

  20. Harris, P. A., Taylor, R., Thielke, R., et al. (2009). Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42(2), 377–381. doi:10.1016/j.jbi.2008.08.010.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Ciampa, P. J., Burlison, J. R., Blevins, M., et al. (2011). Improving retention in the early infant diagnosis of HIV program in rural Mozambique by better service integration. Journal of Acquired Immune Deficiency Syndromes, 58(1), 115–119. doi:10.1097/QAI.0b013e31822149bf.

    Article  PubMed  Google Scholar 

  22. World Health Organization (2013). Supporting pregnant women and new mothers in South Africa Cell-Life’s MAMA SMS.

  23. Baek, C. M. V., Mkhize, S., Friedman, I., Apicella, L., & Rutenberg, N. (2007). Horizons final report: Key findings from an evaluation of the mothers2mothers program in KwaZulu-Natal, South Africa. Washington.

Download references

Acknowledgments

We are grateful to the Witkoppen Health and Welfare Centre team and patients for their time and for making this study possible. The support of Thembisile Makhomboti and all of the staff at the antenatal clinic was essential to this research. We would also like to thank Ntombenhle Shipalana, Nokuthula Mcunu and Mantombi Ntuli at Witkoppen Health and Welfare Centre for assistance with this study and for the dedication they provided to the participants. Clarence Potter at the North Carolina Translational and Clinical Sciences Institute provided the study with REDCap database support. This study was funded by the United States Agency for International Development (USAID) under award number AID-674-1200033. Sheree Schwartz received support for this work from the UJMT Fogarty Grant, supported by the Fogarty International Center of the National Institutes of Health under Award Number R25TW009340. SS, KC, AVR, JB & AP conceived of the study; the study was implemented by NY, SS, KC, JB and MR. Data analysis was done by SS. Writing, interpretation of results and intellectual contribution to the paper were contributed by all authors. All authors have read and approved the text as submitted. The content is solely the responsibility of the authors and does not necessarily represent the official views of USAID or the National Institutes of Health.

Conflict of interest

There are no conflicts of interest to declare.

Author information

Authors and Affiliations

  1. 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 R. Schwartz, Kate Clouse, Annelies Van Rie & Audrey Pettifor

  2. Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Sheree R. Schwartz

  3. Witkoppen Health and Welfare Centre, Johannesburg, South Africa

    Nompumelelo Yende, Jean Bassett & Mamothe Ratshefola

Authors
  1. Sheree R. Schwartz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kate Clouse
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nompumelelo Yende
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Annelies Van Rie
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jean Bassett
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mamothe Ratshefola
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Audrey Pettifor
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sheree R. Schwartz.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 15 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schwartz, S.R., Clouse, K., Yende, N. et al. 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. Matern Child Health J 19, 2029–2037 (2015). https://doi.org/10.1007/s10995-015-1715-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-015-1715-0

Keywords

Search

Navigation