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Changes in Adherence and Viral Load Suppression Among People with HIV in Manila: Outcomes of the Philippines Connect for Life Study

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Abstract

The Philippines HIV epidemic is among the fastest growing globally. Infections among men who have sex with men are rising at an alarming rate, necessitating targeted evidence-based interventions to retain people living with HIV in care, support adherence, and reach viral suppression. We conducted a 48-week prospective cohort study of 462 participants in which we provided a mobile health (mHealth) adherence support intervention using the Connect for Life platform. We observed an improvement in adherence, with the proportion of participants taking more than 95% of their antiretroviral therapy (ART) doses increasing from 78.6% at baseline to 90.3% at 48 weeks. Among treatment experienced participants, adherence improved significantly (McNemar’s test = 21.88, P < 0.001). Viral load suppression did not change, with 92.6% suppression at baseline and 92.0% at 48 weeks. Illicit drug use was associated with reduced adherence (aOR = 0.56, 95%CI 0.31–1.00, P = 0.05) and being on second-line therapy was associated with poor viral load suppression (aOR = 0.33, 95%CI 0.14–0.78, P = 0.01). Quality of life improved following ART initiation, from a mean of 84.6 points (of a possible 120) at baseline to 91.01 at 48 weeks. Due to technical issues, fidelity to the intended intervention was low, with 22.1% (102/462) of participants receiving any voice calls and most others receiving a scaled-back SMS intervention. The mHealth intervention did not have any observed effect on adherence or on viral load suppression. While evidence of effectiveness of mHealth adherence interventions is mixed, these platforms should continue to be explored as part of differentiated treatment support services.

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Data Availability

The datasets generated during and/or analyzed during the current study are not publicly available until after the study outcome evaluation is complete, but are available from the corresponding author upon reasonable request.

References

  1. Joint United Nations Programme on HIV/AIDS (UNAIDS). Philippines country data 2020. 2020.

  2. National HIV/AIDS & STI Surveillance and Strategic Information Unit. HIV/AIDS and ART Registry of the Philippines (HARP) report March 2022. Manila: National HIV/AIDS & STI Surveillance and Strategic Information Unit; 2022.

    Google Scholar 

  3. UNAIDS. The global AIDS strategy 2021–2026. Geneva: UNAIDS; 2021.

    Google Scholar 

  4. UNAIDS. Country factsheets: Philippines. AIDSinfo. Geneva: UNAIDS; 2021.

    Google Scholar 

  5. Eustaquio PC, Docken SS, Leyritana KT, Wulandari LPL. HIV care cascade among cisgender men who have sex with men in a key population-led community center in the Philippines. Int J STD AIDS. 2021;32(8):718–28.

    Article  PubMed  Google Scholar 

  6. Philippine Health Insurance Corporation. Outpatient HIV/AIDS treatment (OHAT) package (revision 2). 2021.

  7. Ortego C, Huedo-Medina TB, Llorca J, Sevilla L, Santos P, Rodríguez E, Warren MR, Vejo J. Adherence to highly active antiretroviral therapy (HAART): a meta-analysis. AIDS Behav. 2011;15(7):1381–96.

    Article  PubMed  Google Scholar 

  8. Jiamsakul A, Kumarasamy N, Ditangco R, Li PCK, Phanuphak P, Sirisanthana T, Sungkanuparph S, Kantipong P, Lee CKC, Mustafa M, Merati TP, Kamarulzaman A, Singtoroj T, Law M. Factors associated with suboptimal adherence to antiretroviral therapy in Asia. J Int AIDS Soc. 2014;17:1–9.

    Article  Google Scholar 

  9. Bangsberg DR, Hecht FM, Charlebois ED, Zolopa AR, Holodniy M, Sheiner L, Bamberger JD, Chesney MA, Moss A. Adherence to protease inhibitors, HIV-1 viral load, and development of drug resistance in an indigent population. AIDS. 2000;14(4):357–66.

    Article  CAS  PubMed  Google Scholar 

  10. Paterson DL, Swindells S, Mohr J, Brester M, Vergis EN, Squier C, Wagener MM, Singh N, Hudson B. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133(1):21–30.

    Article  CAS  PubMed  Google Scholar 

  11. Ammassari A, Trotta MP, Shalev N, Marconi P, Antinori A. Beyond virological suppression: the role of adherence in the late HAART era. Antivir Ther. 2012;17(5):785–92.

    Article  CAS  PubMed  Google Scholar 

  12. Bezabhe WM, Chalmers L, Bereznicki LR, Peterson GM. Adherence to antiretroviral therapy and virologic failure: a meta-analysis. Medicine. 2016;95(15):e3361.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Bangsberg DR. Less than 95% adherence to nonnucleoside reverse-transcriptase inhibitor therapy can lead to viral suppression. Clin Infect Dis. 2006;43(7):939–41.

    Article  CAS  PubMed  Google Scholar 

  14. Harrigan PR, Hogg RS, Dong WWY, Yip B, Wynhoven B, Woodward J, Brumme CJ, Brumme ZL, Mo T, Alexander CS, Montaner JSG. Predictors of HIV drug-resistance mutations in a large antiretroviral-naive cohort initiating triple antiretroviral therapy. J Infect Dis. 2005;191(3):339–47.

    Article  CAS  PubMed  Google Scholar 

  15. Tam LWY, Chui CKS, Brumme CJ, Bangsberg DR, Montaner JSG, Hogg RS, Harrigan PR. The relationship between resistance and adherence in drug-naive individuals initiating HAART is specific to individual drug classes. J Acquir Immune Defic Syndr. 2008;49(3):266–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Bangsberg DR, Perry S, Charlebois ED, Clark RA, Roberston M, Zolopa AR, Moss A. Non-adherence to highly active antiretroviral therapy predicts progression to AIDS. AIDS. 2001;15(9):1181–3.

    Article  CAS  PubMed  Google Scholar 

  17. Hogg RS, Heath K, Bangsberg D, Yip B, Press N, O’Shaughnessy MV, Montaner JSG. Intermittent use of triple-combination therapy is predictive of mortality at baseline and after 1 year of follow-up. AIDS. 2002;16(7):1051–8.

    Article  PubMed  Google Scholar 

  18. Dowshen N, Johnson A, Holoyda BJ, Garofalo R. Improving adherence to antiretroviral therapy for youth living with HIV/AIDS: a pilot study using personalized, interactive, daily text message reminders. J Med Internet Res. 2012;14(2):e51. https://doi.org/10.2196/jmir.2015.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Safren SA, Biello KB, Smeaton L, Mimiaga MJ, Walawander A, Lama JR, Rana A, Nyirenda M, Kayoyo VM, Samaneka W, Joglekar A, Celentano D, Martinez A, Remmert JE, Nair A, Lalloo UG, Kumarasamy N, Hakim J, Campbell TB. Psychosocial predictors of non-adherence and treatment failure in a large scale multi-national trial of antiretroviral therapy for HIV: data from the ACTG A5175/PEARLS trial. PLoS ONE. 2014. https://doi.org/10.1371/journal.pone.0104178.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Grierson J, Koelmeyer RL, Smith A, Pitts M. Adherence to antiretroviral therapy: factors independently associated with reported difficulty taking antiretroviral therapy in a national sample of HIV-positive Australians. HIV Med. 2011;12(9):562–9.

    Article  CAS  PubMed  Google Scholar 

  21. Chesney MA, Ickovics JR, Chambers DB, Gifford AL, Neidig J, Zwickl B, Wu AW. Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. AIDS Care. 2000;12(3):255–66.

    Article  CAS  PubMed  Google Scholar 

  22. Santos AP. Dying of shame and AIDS in the Philippines. Deutsche Welle Manila; 2016. Available from: http://www.dw.com/en/dying-of-shame-and-aids-in-the-philippines/a-19292896.

  23. Santos AP. Sex and sensibilities podcast: HIV epidemic in the PH. Rappler Manila; 2015.

  24. Gangcuangco LMA. HIV crisis in the Philippines: urgent actions needed. Lancet Public Health. 2019;4(2):e84. https://doi.org/10.1016/s2468-2667(18)30265-2.

    Article  PubMed  Google Scholar 

  25. O’Connor C, Leyritana K, Doyle AM, Lewis JJ, Gill R, Salvaña EM. Interactive mobile phone HIV adherence support for men who have sex with men in the Philippines connect for life study: mixed methods approach to intervention development and pilot testing. JMIR Form Res. 2022;6(2):e30811. https://doi.org/10.2196/30811.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Free C, Phillips G, Galli L, Watson L, Felix L, Edwards P, Patel V, Haines A. The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS Med. 2013;10(1):e100136229.

    Article  Google Scholar 

  27. Schnall R, Bakken S, Rojas M, Travers J, Carballo-dieguez A. mHealth technology as a persuasive tool for treatment, care and management of persons living with HIV. AIDS Behav. 2015;19:S81–9. https://doi.org/10.1007/s10461-014-0984-8.

    Article  Google Scholar 

  28. Lester RT, Ritvo P, Mills EJ, Kariri A, Karanja S, Chung MH, Jack W, Habyarimana J, Sadatsafavi M, Najafzadeh M, Marra CA, Estambale B, Ngugi E, Ball TB, Thabane L, Gelmon LJ, Kimani J, Ackers M, Plummer FA. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. The Lancet. 2010;376(9755):1838–45.

    Article  Google Scholar 

  29. Finitsis DJ, Pellowski JA, Johnson BT. Text message intervention designs to promote adherence to antiretroviral therapy (ART): a meta-analysis of randomized controlled trials. PLoS ONE. 2014;9(2):e88166.

    Article  PubMed  PubMed Central  ADS  Google Scholar 

  30. Mbuagbaw L, Thabane L, Ongolo-Zogo P, Lester RT, Mills EJ, Smieja M, Dolovich L, Kouanfack C. The Cameroon Mobile Phone SMS (CAMPS) trial: a randomized trial of text messaging versus usual care for adherence to antiretroviral therapy. PLoS ONE. 2012;7(12):6–12.

    Article  Google Scholar 

  31. Kanters S, Park JJH, Chan K, Socias ME, Ford N, Forrest JI, Thorlund K, Nachega JB, Mills EJ. Interventions to improve adherence to antiretroviral therapy: a systematic review and network meta-analysis. Lancet HIV. 2017;4(1):e31–40.

    Article  PubMed  Google Scholar 

  32. Mbuagbaw L, Mursleen S, Lytvyn L, Smieja M, Dolovich L, Thabane L. Mobile phone text messaging interventions for HIV and other chronic diseases: an overview of systematic reviews and framework for evidence transfer. BMC Health Serv Res. 2015;15:33.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Mbuagbaw L, Sivaramalingam B, Navarro T, Hobson N, Keepanasseril A, Wilczynski NJ, Haynes BR, Team the PAR. Interventions for enhancing adherence to antiretroviral therapy (ART): a systematic review of high quality studies. AIDS Patient Care STDS. 2015;29(5):248–66.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Aranda-Jan CB, Mohutsiwa-Dibe N, Loukanova S. Systematic review on what works, what does not work and why of implementation of mobile health (mHealth) projects in Africa. BMC Public Health. 2014;14(1):188.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Park LG, Howie-Esquivel J, Dracup K. A quantitative systematic review of the efficacy of mobile phone interventions to improve medication adherence. J Adv Nurs. 2014;70(9):1932–53.

    Article  PubMed  Google Scholar 

  36. Shah R, Watson J, Free C. A systematic review and meta-analysis in the effectiveness of mobile phone interventions used to improve adherence to antiretroviral therapy in HIV infection. BMC Public Health. 2019. https://doi.org/10.1186/s12889-019-6899-6.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Demena BA, Artavia-Mora L, Ouedraogo D, Thiombiano BA, Wagner N. A systematic review of mobile phone interventions (SMS/IVR/calls) to improve adherence and retention to antiretroviral treatment in low- and middle-income countries. AIDS Patient Care STDS. 2020. https://doi.org/10.1089/apc.2019.0181.

    Article  PubMed  Google Scholar 

  38. Chib A, Van VMH, Car J, Chib A, Helena M. mHealth adoption in low-resource environments: a review of the use of mobile healthcare in developing countries mHealth adoption in low-resource environments: a review of the use of mobile healthcare in developing countries. J Health Commun. 2015;20(1):4–34. https://doi.org/10.1080/10810730.2013.864735.

    Article  PubMed  Google Scholar 

  39. World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach: second edition. Geneva: World Health Organization; 2016. Available from: https://www.who.int/publications/i/item/9789241549684.

  40. O’Connor C, Leyritana K, Doyle AM, Birdthistle I, Lewis JJ, Gill R, Salvaña EM. Delivering an mHealth adherence support intervention for patients with HIV: mixed methods process evaluation of the Philippines connect for life study. JMIR Form Res. 2022. https://doi.org/10.2196/37163.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Murthy N, Chandrasekharan S, Prakash MP, Ganju A, Peter J, Kaonga N, Mechael P. Effects of an mHealth voice message service (mMitra) on maternal health knowledge and practices of low-income women in India: findings from a pseudo-randomized controlled trial. BMC Public Health. 2020;20(1):1–10.

    Article  Google Scholar 

  42. Johnson & Johnson India. mMitra: connecting more moms via mobile. 2017. Available from: https://www.jnj.com/our-giving/mmitra-connecting-more-moms-via-mobile. Accessed 30 Dec 2021.

  43. Parkes-Ratanshi RM, Nabaggala MS, Bwanika AN, Lamorde M, King R, Owarwo N, Odongpiny EAL, Orama R, Castelnuovo B, Kiragga A. Call for life Uganda TM: an RCT using interactive voice response for PLHIV on art. Top Antivir Med. 2019;27(SUPPL 1):405s–6s.

    Google Scholar 

  44. Byonanebye DM, Nabaggala MS, Naggirinya AB, Lamorde M, Oseku E, King R, Owarwo N, Laker E, Orama R, Castelnuovo B, Kiragga A, Parkes-Ratanshi R. An interactive voice response software to improve the quality of life of people living with HIV in Uganda: randomized controlled trial. JMIR mHealth uHealth. 2021;9(2):1–16.

    Article  Google Scholar 

  45. Michie S, Atkins L, West R. The behaviour change wheel: a guide to designing interventions. 2014. ISBN:978-1-291-84605-8.

  46. Fisher JD, Amico KR, Fisher WA, Harman JJ. The information-motivation-behavioral skills model of antiretroviral adherence and its applications. Curr HIV/AIDS Rep. 2008;5(4):193–203.

    Article  PubMed  Google Scholar 

  47. Krishnan A, Ferro EG, Weikum D, Vagenas P, Lama JR, Sanchez J, Altice FL. Communication technology use and mHealth acceptance among HIV-infected men who have sex with men in Peru: implications for HIV prevention and treatment. AIDS Care. 2014;0121(October):1–10.

    Google Scholar 

  48. Uhrig JD, Lewis MA, Bann CM, Harris JL, Furberg D, Coomes CM, Kuhns LM, Uhrig JD, Lewis MA, Bann CM, Harris JL, Furberg RD, Coomes CM, Kuhns LM, Hiv A, Uhrig JD, Lewis MA, Bann CM, Harris JL, Furberg RD, Coomes CM, Kuhns LM. Addressing HIV knowledge, risk reduction, social support, and patient involvement using SMS: results of a proof-of-concept study addressing HIV knowledge, risk reduction, social support, and patient involvement using SMS: results of a proof-of-con. J Health Commun. 2012;17(Sup1):128–45. https://doi.org/10.1080/10810730.2011.649156.

    Article  PubMed  Google Scholar 

  49. UNAIDS. UNAIDS meeting report: information and communications technologies: engaging the private sector and communities in HIV programmes with gay men and other men who have sex with men. 2016. https://doi.org/10.1057/9781137542809_11.

  50. Schnall R, Travers J, Rojas M, Carballo-Diéguez A. eHealth interventions for HIV prevention in high-risk men who have sex with men: a systematic review. J Med Internet Res. 2014;16(5):1–10.

    Article  Google Scholar 

  51. Carey MP, Schroder KEE. Development and psychometric evaluation of the brief HIV knowledge questionnaire. AIDS Educ Prev. 2002;14(2):172–82. https://doi.org/10.1521/aeap.14.2.172.23902.

    Article  PubMed  PubMed Central  Google Scholar 

  52. World Health Organization. WHOQOL-HIV BREF, 2012 revision. Geneva: World Health Organization; 2002.

    Google Scholar 

  53. World Health Organization. WHOQOL-HIV instrument: scoring and coding for the WHOQOL-HIV instruments: users manual, 2012 revision. WHOQOL-HIV instrument users manual. Geneva: World Health Organization; 2002.

    Google Scholar 

  54. NIH. Drinking levels defined. National Institute on Alcohol Abuse and Alcoholism (NIAAA). 2011. p. 5–6. Available from: https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking.

  55. Carliner H, Mauro PM, Brown QL, Shmulewitz D, Rahim-Juwel R, Sarvet AL, Wall MM, Martins SS, Carliner G, Hasin DS. Key substance use and mental health indicators in the United States. Drug Alcohol Depend. 2017;170:51–8.

    Article  PubMed  Google Scholar 

  56. Torres TS, Harrison LJ, La Rosa AM, Cardoso SW, Zheng L, Ngongondo M, Some F, Lalloo UG, Mwelase T, Collier AC, Hughes MD. Quality of life improvement in resource-limited settings after one year of second-line antiretroviral therapy use among adult men and women. AIDS. 2018;32(5):583–93. https://doi.org/10.1097/QAD.0000000000001738.

    Article  PubMed  Google Scholar 

  57. Dutra BS, Lédo AP, Lins-Kusterer L, Luz E, Prieto IR, Brites C. Changes health-related quality of life in HIV-infected patients following initiation of antiretroviral therapy: a longitudinal study. Braz J Infect Dis. 2019;23(4):211–7.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Lifson AR, Grund B, Gardner EM, Kaplan R, Denning E, Engen N, Carey CL, Chen F, Dao S, Florence E, Sanz J, Emery S. Improved quality of life with immediate versus deferred initiation of antiretroviral therapy in early asymptomatic HIV infection. AIDS. 2017;31(7):953–63. https://doi.org/10.1097/QAD.0000000000001417.

    Article  PubMed  Google Scholar 

  59. Philippines Department of Health. Department of Health Administrative order 2014-0031: policies and guidelines on the use of antiretroviral therapy (ART) among people living with human immunodeficiency virus and HIV-exposed infants. 2014.

  60. Philippines Department of Health. Department of Health Administrative order 2018-0024: revised policies and guidelines on the use of antiretroviral therapy (ART) among people living with human immunodeficiency virus and HIV-exposed infants. 2018. Available from: https://doh.gov.ph/sites/default/files/health_programs/ao2018-0024.pdf.

  61. Salvana EMT, Samonte GMJ, Telan E, Leyritana K, Tactacan-Abrenica RJ, Ching PR, Arevalo GM, Dungca NT, Peñalosa-Ramos C, Mendoza KAR, Trinidad LF, dela Tonga A, Lim J, Destura R, Alejandria M, Solante R, Arcangel L, Palaypayon NS, Schwem BE. High rates of tenofovir failure in a CRF01_AE-predominant HIV epidemic in the Philippines. Int J Infect Dis Int Soc Infect Dis. 2020;95:125–32.

    Article  CAS  Google Scholar 

  62. Dungca NT, Schwem B, Arevalo G, Li KL, Salvana EM. 1257. Antiretroviral treatment failure in a prospective cohort of persons living with HIV in the Philippines. Open Forum Infect Dis. 2022. https://doi.org/10.1093/ofid/ofac492.1088.

    Article  Google Scholar 

  63. John ME, Chipwaza B. HIV status disclosure among adults attending care and treatment clinic in Kilombero district, South-Eastern Tanzania. Int J Afr Nurs Sci. 2022;17(May):100434. https://doi.org/10.1016/j.ijans.2022.100434.

    Article  Google Scholar 

  64. Peng W, Song X, Zhang C, Chen Y, Zhou Q, Välimäki MA, Li X. The proportion of HIV disclosure to sexual partners among people diagnosed with HIV in China: a systematic review and meta-analysis. Front Public Health. 2022;10:1004869.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Elsayed H, O’Connor C, Leyritana K, Salvana E, Cox SE. Depression, nutrition, and adherence to antiretroviral therapy in men who have sex with Men in Manila, Philippines. Front Public Health. 2021;9(September):1–10. https://doi.org/10.3389/fpubh.2021.644438.

    Article  CAS  Google Scholar 

  66. O’Connor C, Leyritana K, Calica K, Gill R, Doyle AM, Lewis JJ, Salvaña EM. Risk factors affecting adherence to antiretroviral therapy among HIV patients in Manila, Philippines: a baseline cross-sectional analysis of the Philippines Connect for Life Study. Sex Health. 2021;18(1):95–103.

    Article  PubMed  Google Scholar 

  67. Hoenigl M, Chaillon A, Moore DJ, Morris SR, Smith DM, Little SJ. Clear links between starting methamphetamine and increasing sexual risk behavior: a cohort study among men who have sex with men clear links between starting methamphetamine and increasing sexual risk behavior: a cohort study among men who have sex with me. J Acquir Immune Defic Syndr. 2016;71(5):551–7. https://doi.org/10.1097/QAI.0000000000000888.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Human Rights Watch. Fueling the Philippines’ HIV epidemic: government barriers to condom use by men who have sex with men. 2016. Available from: https://www.hrw.org/sites/default/files/report_pdf/philippines1216_web.pdf.

  69. Dombrowski JC, Dorabjee J, Strathdee SA, Diego S. Atrocity in the Philippines: how Rodrigo Duterte’s war on drug users may exacerbate the burgeoning HIV epidemic. J Acquir Immune Defic Syndr. 2017;76(1):23–5. https://doi.org/10.1097/QAI.0000000000001464.Atrocity.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Alibudbud R. Expanding pre-exposure prophylaxis (PrEP) utilization in the Philippine HIV crisis. J Prim Care Community Health. 2023;14:215013192311636. https://doi.org/10.1177/21501319231163643.

    Article  Google Scholar 

  71. Philippines Department of Health. Philippines Interim National PrEP guidelines 2021. 2021. Available from: https://www.prepwatch.org/resources/philippines-interim-national-prep-guidelines-2021/. Accessed 10 Sept 2023.

  72. Da Costa TM, Barbosa BJP, Gomes e Costa DA, Sigulem D, De Fátima Marin H, Filho AC, Pisa IT. Results of a randomized controlled trial to assess the effects of a mobile SMS-based intervention on treatment adherence in HIV/AIDS-infected Brazilian women and impressions and satisfaction with respect to incoming messages. Int J Med Inform. 2012;81(4):257–69.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Orrell C, Cohen K, Mauff K, Bangsberg DR, Maartens G, Wood R. A randomized controlled trial of real-time electronic adherence monitoring with text message dosing reminders in people starting first-line antiretroviral therapy. J Acquir Immune Defic Syndr. 2015;70(5):495–502.

    Article  PubMed  Google Scholar 

  74. Haberer JE, Musiimenta A, Atukunda EC, Musinguzi N, Wyatt MA, Ware NC, Bangsberg DR. Short message service (SMS) reminders and real-time adherence monitoring improve antiretroviral therapy adherence in rural Uganda. AIDS. 2016;30(8):1295–9.

    Article  CAS  PubMed  Google Scholar 

  75. Dillingham R, Ingersoll K, Flickinger TE, Waldman AL, Grabowski M, Laurence C, Wispelwey E, Reynolds G, Conaway M, Cohn WF. PositiveLinks: a mobile health intervention for retention in HIV care and clinical outcomes with 12-month follow-up. AIDS Patient Care STDS. 2018;32(6):241–50.

    Article  PubMed  PubMed Central  Google Scholar 

  76. UNAIDS. Ensuring that people living with HIV in the Philippines have access to treatment during COVID-19. unaids.org. 2020. p. 2020–22. Available from: https://www.unaids.org/en/resources/presscentre/featurestories/2020/april/20200408_philippines. Accessed 30 Jan 2022.

  77. UNAIDS. Community-led HIV services stepped up in the Philippines during the COVID-19 pandemic. unaids.org. 2021. Available from: https://www.unaids.org/en/resources/presscentre/featurestories/2021/may/20210511_philippines. Accessed 30 Oct 2022.

  78. Alibudbud R. The Philippine HIV crisis and the COVID-19 pandemic: a worsening crisis. Public Health. 2021;200(January):e1. https://doi.org/10.1016/j.puhe.2021.09.008.

    Article  PubMed  Google Scholar 

  79. Hung CC, Banerjee S, Gilada I, Green K, Inoue Y, Kamarulzaman A, Leyritana K, Phanuphak N, Wong T, Wong TH, Singh S, Choi JY. Impact of COVID-19 on the HIV care continuum in Asia: insights from people living with HIV, key populations, and HIV healthcare providers. PLoS ONE. 2022;17(7):1–18.

    Article  Google Scholar 

  80. Finitsis DJ, Pellowski JA, Huedo-Medina TB, Fox MC, Kalichman SC. Visual analogue scale (VAS) measurement of antiretroviral adherence in people living with HIV (PLWH): a meta-analysis. J Behav Med. 2016;39(6):1043–55.

    Article  PubMed  Google Scholar 

  81. Kabore L, Muntner P, Chamot E, Zinski A, Burkholder G, Mugavero MJ. Self-report measures in the assessment of antiretroviral medication adherence: comparison with medication possession ratio and HIV viral load. J Int Assoc Provid AIDS Care. 2015;14(2):156–62.

    Article  PubMed  Google Scholar 

  82. Buscher A, Hartman C, Kallen M, Giordano T. Validity of self-report measures in assessing antiretroviral adherence of newly diagnosed, HAART-Naïve, HIV patients. HIV Clin Trials. 2011;12(5):244–54.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

This study received sponsorship from Johnson & Johnson Global Public Health. We are thankful to our collaborators in the Johnson & Johnson team for developing the Connect for LifeTM platform and for their extensive work to tailor the technology to the Philippine setting: Randeep Gill, Paula McKenna, Piet Knaepen, Avinash Agrawal, and Jurgen de Beckker. Furthermore, this study would not have been possible without the efforts of our implementing partner the STI/AIDS Guidance Intervention & Prevention Unit at the Philippine General Hospital. Thank you to Cari Free, Ford Hickson, and James Hargreaves at London School of Hygiene and Tropical Medicine for their guidance during protocol development, especially regarding intervention development, behavior change theory, and process evaluation methodology.

Funding

This study received sponsorship from Johnson & Johnson Global Public Health.

Author information

Authors and Affiliations

  1. Sustained Health Initiatives of the Philippines (SHIP), Mandaluyong, Philippines

    Cara O’Connor & Katerina Leyritana

  2. The London School of Hygiene and Tropical Medicine, London, UK

    Cara O’Connor

  3. Anova Health Institute, 12 Sherborne Ave. Parktown, Johannesburg, South Africa

    Cara O’Connor

  4. MRC International Statistics & Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK

    Aoife M. Doyle

  5. Y Lab, the Public Services Innovation Lab for Wales, School of Social Sciences, Cardiff University, Cardiff, UK

    James J. Lewis

  6. Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines Manila, Ermita, Manila, Philippines

    Edsel Maurice Salvaña

  7. Section of Infectious Disease, Department of Medicine, University of the Philippines College of Medicine, University of the Philippines Manila, Ermita, Manila, Philippines

    Edsel Maurice Salvaña

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  1. Cara O’Connor
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  2. Katerina Leyritana
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  3. Aoife M. Doyle
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  4. James J. Lewis
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  5. Edsel Maurice Salvaña
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CO: Co-principal Investigator responsible for protocol development, data collection and analysis, development of manuscript. Trustee, Sustained Health Initiatives of the Philippines (SHIP). KL: Co-investigator responsible for medical services provision to patients in SHIP clinic. Medical Director, SHIP. Provided editorial input on manuscript. AMD: PhD co-supervisor, responsible for technical input on data analysis plan and editorial input on manuscript. Associate Professor of Epidemiology, LSHTM. JJL: Co-investigator and PhD co-supervisor responsible for technical input on protocol development and data analysis plan and editorial input on manuscript. Professor, Cardiff University. EMS: Co-principal Investigator responsible for oversight of research protocol. Provided editorial input on manuscript. Clinician at STI/AIDS Guidance Intervention & Prevention Unit at the Philippine General Hospital.

Corresponding author

Correspondence to Cara O’Connor.

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Competing Interests

The authors declare that they have no competing interests. The study was funded through a sponsorship agreement with Johnson & Johnson Global Public Health (J&J), the developer of the Connect for Life™ platform. Per the licensing agreement all platform content and data are owned solely by the licensee (SHIP). While J&J had a collaborative role in the intervention development phase, all data collection and analysis herein were conducted by the study team at Sustained Health Initiatives of the Philippines.

Ethical Approval

Ethical clearance for the study was obtained from the University of the Philippines Manila Research Ethics Board (protocol number 2016-265-01) and from the London School of Hygiene and Tropical Medicine (reference number 11631).

Consent to Participate

All participants provided written consent prior to inclusion in the study. All data collection and reporting is compliant with national privacy laws, and no report will allow an individual participant to be identified.

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Not applicable.

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O’Connor, C., Leyritana, K., Doyle, A.M. et al. Changes in Adherence and Viral Load Suppression Among People with HIV in Manila: Outcomes of the Philippines Connect for Life Study. AIDS Behav 28, 837–853 (2024). https://doi.org/10.1007/s10461-023-04190-1

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