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Short Message Service (SMS) Surveys Assessing Pre-exposure Prophylaxis (PrEP) Adherence and Sexual Behavior are Highly Acceptable Among HIV-Uninfected Members of Serodiscordant Couples in East Africa: A Mixed Methods Study

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Abstract

Short message service (SMS) surveys are a promising data collection method and were used to measure sexual behavior and adherence to HIV pre-exposure prophylaxis (PrEP) among HIV-uninfected partners of serodiscordant couples enrolled in a sub-study of the Partners Demonstration Project (an open-label study of integrated antiretroviral therapy and PrEP for HIV prevention in Kenya and Uganda). Questionnaires were completed by 142 participants after study exit. Median age was 29 years; 69% were male. Ninety-five percent (95%) felt SMS surveys were “easy” or “very easy”, 74% reported no challenges, and 72% preferred SMS surveys over in-person study visits. Qualitative interviews involving 32 participants confirmed the ease of responding to SMS surveys. Participants also indicated that surveys acted as reminders for adherence to PrEP and condom use and were experienced as support from the study. SMS surveys were generally found to be acceptable in this population and provided real-time context of PrEP use.

Resumen

Las encuestas del servicio de mensajes cortos (SMS) son un método de recopilación de datos prometedor y se utilizaron para medir el comportamiento sexual y la adherencia a la profilaxis previa a la exposición al VIH (PrEP) entre los socios VIH-no infectados de las parejas serodiscordantes inscritas en un subestudio de la Proyecto de Demostración de Partners (estudio de etiqueta abierta de la terapia antirretroviral integrada y PrEP para prevention del VIH en Kenia y Uganda). Los cuestionarios fueron completados por 142 participantes después de la salida del estudio. La edad mediana era 29 años; 69% eran varones. El 95 por ciento (95%) consideró que las encuestas de SMS eran “fáciles” o “muy fáciles”, 74% no reportaron ningún dificultades y 72% prefirieron encuestas de SMS sobre visitas de estudio en persona. Las entrevistas cualitativas que involucraron a 32 participantes confirmaron la facilidad de responder a encuestas SMS. Los participantes también indicaron que las encuestas actuaron como recordatorios para la adherencia a la preparación y el uso del condón y se experimentaron como apoyo del estudio. Por lo general, se encontró que las encuestas por SMS eran aceptables en esta población y proporcionaban un contexto en tiempo real de uso de PrEP.

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References

  1. Baeten JM, Donnell D, Ndase P, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367(5):399–410.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Thigpen MC, Kebaabetswe PM, Paxton LA, et al. Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012;367(5):423–34.

    Article  CAS  PubMed  Google Scholar 

  3. Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Marrazzo JM, Ramjee G, Richardson BA, et al. Tenofovir-based preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2015;372(6):509–18.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Van Damme L, Corneli A, Ahmed K, et al. Preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2012;367(5):411–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Murnane PM, Celum C, Mugo NR, et al. Efficacy of preexposure prophylaxis for HIV-1 prevention among high-risk heterosexuals: subgroup analyses from a randomized trial. AIDS. 2013;27(13):2155–60.

    Article  CAS  PubMed  Google Scholar 

  7. Haberer JE, Bangsberg DR, Baeten JM, et al. Defining success with HIV pre-exposure prophylaxis: a prevention-effective adherence paradigm. AIDS. 2015;29(11):1277–85.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Mutua G, Sanders E, Mugo P, et al. Safety and adherence to intermittent pre-exposure prophylaxis (PrEP) for HIV-1 in African men who have sex with men and female sex workers. PLoS ONE. 2012;7(4):e33103.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Shi L, Liu J, Fonseca V. Correlation between adherence rates measured by MEMS and self-reported questionnaires: a meta-analysis. Health Qual Life Outcomes. 2010;8(1):99.

    Article  PubMed  PubMed Central  Google Scholar 

  10. GMSA. The Mobile Economy. 2017 [cited 2018 5th July]. https://www.gsmaintelligence.com/research/?file=9e927fd6896724e7b26f33f61db5b9d5&download. Accessed 10 July 2018.

  11. Pew Research Center. Mobile Fact Sheet 2018. http://www.pewinternet.org/fact-sheet/mobile/. Accessed 10 July 2018.

  12. Johnson AM, Copas AJ, Erens B, et al. Effect of computer-assisted self-interviews on reporting of sexual HIV risk behaviours in a general population sample: a methodological experiment. AIDS. 2001;15(1):111–5.

    Article  CAS  PubMed  Google Scholar 

  13. Adebajo S, Obianwu O, Eluwa G, et al. Comparison of audio computer assisted self-interview and face-to-face interview methods in eliciting HIV-related risks among men who have sex with men and men who inject drugs in Nigeria. PLoS ONE. 2014;9(1):e81981.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Whitford HM, Donnan PT, Symon AG, et al. Evaluating the reliability, validity, acceptability, and practicality of SMS text messaging as a tool to collect research data: results from the Feeding Your Baby project. J Am Med Inform Assoc. 2012;19(5):744–9.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Haberer JE, Kiwanuka J, Nansera D, Wilson IB, Bangsberg DR. Challenges in using mobile phones for collection of antiretroviral therapy adherence data in a resource-limited setting. AIDS Behav. 2010;14(6):1294–301.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Brown W III, Giguere R, Ibitoye M, Carballo-Diéguez A, Cranston RD. Successfully addressing challenges to implementing a multinational SMS-based reminder and data collection system in a biomedical HIV prevention trial. AIDS Res Hum Retrovir. 2014;30(S1):A87.

    Article  Google Scholar 

  17. Giguere R, Brown W III, Balan IC, et al. Are participants concerned about privacy and security when using short message service to report product adherence in a rectal microbicide trial? J Am Med Inform Assoc. 2018;25(4):393–400.

    Article  PubMed  Google Scholar 

  18. Curran K, Mugo NR, Kurth A, et al. Daily short message service surveys to measure sexual behavior and pre-exposure prophylaxis use among Kenyan men and women. AIDS Behav. 2013;17(9):2977–85.

    Article  PubMed  Google Scholar 

  19. Heffron R, Ngure K, Odoyo J, et al. Pre-exposure prophylaxis for HIV-negative persons with partners living with HIV: uptake, use, and effectiveness in an open-label demonstration project in East Africa. Gates Open Res. 2017;1:3.

    Article  PubMed  Google Scholar 

  20. Uganda Population-based HIV Impact Assessment Report 2017 [cited 2018 8th July]. http://library.health.go.ug/publications/service-delivery-diseases-control-prevention-communicable-diseases/hivaids/uganda-0. Accessed 10 July 2018.

  21. Kenya HIV County Profiles 2016. http://nacc.or.ke/wp-content/uploads/2016/12/Kenya-HIV-County-Profiles-2016.pdf. Accessed 10 July 2018.

  22. Strauss A, Corbin JM. Basics of qualitative research: grounded theory procedures and techniques. Thousand Oaks, CA: Sage Publications; 1990.

    Google Scholar 

  23. Haberer JE, Ngure K, Muwonge T, et al. Brief report: context matters: PrEP adherence is associated with sexual behavior among HIV serodiscordant couples in East Africa. J Acquir Immune Defic Syndr. 2017;76(5):488–92.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Siedner MJ, Santorino D, Haberer JE, Bangsberg DR. Know your audience: predictors of success for a patient-centered texting app to augment linkage to HIV care in rural Uganda. J Med Internet Res. 2015;17(3):e78.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Haberer JE, Baeten JM, Campbell J, et al. Adherence to antiretroviral prophylaxis for HIV prevention: a substudy cohort within a clinical trial of serodiscordant couples in East Africa. PLoS Med. 2013;10(9):e1001511.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Garrison LE, Haberer JE. Technological methods to measure adherence to antiretroviral therapy and pre-exposure prophylaxis. Curr Opin HIV AIDS. 2017;12(5):467–74.

    Article  PubMed  Google Scholar 

  27. Pop-Eleches C, Thirumurthy H, Habyarimana JP, et al. Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. AIDS. 2011;25(6):825–34.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Campbell JI, Eyal N, Musiimenta A, Haberer JE. Ethical questions in medical electronic adherence monitoring. J Gen Intern Med. 2016;31(3):338–42.

    Article  PubMed  Google Scholar 

  29. Richardson HS, Eyal N, Campbell JI, Haberer JE. When ancillary care clashes with study aims. N Engl J Med. 2017;377(13):1213–5.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Haberer JE, Kahane J, Kigozi I, et al. Real-time adherence monitoring for HIV antiretroviral therapy. AIDS Behav. 2010;14(6):1340–6.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Xiao Y, Ji G, Tian C, Li H, Biao W, Hu Z. Acceptability, and factors associated with willingness to receive short messages for improving antiretroviral therapy adherence in China. AIDS Care. 2014;26(8):952.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We acknowledge the research participants, the partners demonstration project team, the Partners Mobile Adherence to PrEP (PMAP) team, the funders of the Partners Demonstration Project (National Institute of Mental Health of the US National Institutes of Health grant R01MH095507, the Bill & Melinda Gates Foundation grant OPP47674, OPP1056051, and through the generous support of the American people through the US Agency for International Development cooperative agreement AID-OAA-A-12-00023), the funders of the PMAP sub-study (National Institute of Mental Health Grant R01MH098744) and Gilead Sciences that donated PrEP medication.

PMAP Team: Massachusetts General Hospital and Harvard Medical School (Jessica Haberer [Principal Investigator], David Bangsberg); University of Washington (Jared Baeten, Connie Celum, Deborah Donnell, Renee Heffron, Lara Kidoguchi, Kathleen Thomas); Thika, Kenya site (Nelly Mugo, Kenneth Ngure, Njambi Njuguna, Gakuo Maina, Edwin Mugo, Lawrence Mwaniki, Grace Kimemia, Peter Mogere, Sarah Mbaire, Peter Mwaniki, John Njoroge, Snaidah Ongachi, Linnet Makena, Peter Michira, Simon Mburu.; Kampala, Uganda site (Elly Katabira, Andrew Mujugira, Timothy Muwonge, Nulu Bulya, Felix Bambia, Ronald Kiranda, Betty Nankya, Agnes Nakyanzi, Charles Brown, Alice Ssebbaale, Edith Nakku Joloba, Robert Kikulwe Nyanzi, James Mutyaba, Miriam Nampala, Florence Nambi, Emma Okwero, Samuel Kirimunda, Diego Izizinga, Joseph Kibuuka, Carol Musubika.

Funding

The funders had no role in data collection or analysis and the results and interpretation presented here do not necessarily reflect the views of the study funders.

Author information

Author notes

  1. Timothy R. Muwonge and Kenneth Ngure have contributed equally.

Authors and Affiliations

  1. Infectious Disease Institute, Makerere University, Box 22418, Kampala, Uganda

    Timothy R. Muwonge, Elly Katabira & Felix Bambia

  2. School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya

    Kenneth Ngure

  3. Centers for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya

    Nelly Mugo & Grace Kimemia

  4. Department of Global Health, University of Washington, Seattle, USA

    Nelly Mugo, Jared M. Baeten & Renee Heffron

  5. Massachusetts General Hospital, Boston, USA

    Bridget Frances O’Rourke Burns & Jessica E. Haberer

  6. Global Health Collaborative, Mbarara University of Science and Technology, Mbarara, Uganda

    Nicholas Musinguzi

  7. Department of Medicine, University of Washington, Seattle, USA

    Jared M. Baeten

  8. Department of Epidemiology, University of Washington, Seattle, USA

    Jared M. Baeten & Renee Heffron

  9. Harvard Medical School, Boston, USA

    Jessica E. Haberer

Authors
  1. Timothy R. Muwonge
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Consortia

the Partners Mobile Adherence to PrEP (PMAP) Team

  • Jessica Haberer
  • , David Bangsberg
  • , Jared Baeten
  • , Connie Celum
  • , Deborah Donnell
  • , Renee Heffron
  • , Lara Kidoguchi
  • , Kathleen Thomas
  • , Nelly Mugo
  • , Kenneth Ngure
  • , Njambi Njuguna
  • , Gakuo Maina
  • , Edwin Mugo
  • , Lawrence Mwaniki
  • , Grace Kimemia
  • , Peter Mogere
  • , Sarah Mbaire
  • , Peter Mwaniki
  • , John Njoroge
  • , Snaidah Ongachi
  • , Linnet Makena
  • , Peter Michira
  • , Simon Mburu
  • , Elly Katabira
  • , Andrew Mujugira
  • , Timothy Muwonge
  • , Nulu Bulya
  • , Felix Bambia
  • , Ronald Kiranda
  • , Betty Nankya
  • , Agnes Nakyanzi
  • , Charles Brown
  • , Alice Ssebbaale
  • , Edith Nakku Joloba
  • , Robert Kikulwe Nyanzi
  • , James Mutyaba
  • , Miriam Nampala
  • , Florence Nambi
  • , Emma Okwero
  • , Samuel Kirimunda
  • , Diego Izizinga
  • , Joseph Kibuuka
  •  & Carol Musubika

Corresponding author

Correspondence to Timothy R. Muwonge.

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Conflict of interest

We declare that we have no conflicts of interest.

Ethical Approval

The study protocol, informed consent forms, recruitment materials, and other requested documents and any subsequent modifications were reviewed and approved by the Uganda National Council of Science and Technology and the Kenya National Council of Science and Technology, Massachusetts General Hospital, and the University of Washington.

Additional information

The members of the Partners Mobile Adherence to PrEP (PMAP) Team were listed in acknowledgements.

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Muwonge, T.R., Ngure, K., Katabira, E. et al. Short Message Service (SMS) Surveys Assessing Pre-exposure Prophylaxis (PrEP) Adherence and Sexual Behavior are Highly Acceptable Among HIV-Uninfected Members of Serodiscordant Couples in East Africa: A Mixed Methods Study. AIDS Behav 23, 1267–1276 (2019). https://doi.org/10.1007/s10461-018-2326-8

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  • DOI: https://doi.org/10.1007/s10461-018-2326-8

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