Internet and cell phone as tools to support antiretroviral therapy adherence among HIV infected patients aged above 18 years attending Kenyatta national hospital

Abstract

World Health Organisation has been advocating for increased provision of Antiretroviral Therapy (ART) to lower Human Immunodeficiency Virus (HIV) prevalence. Embracing the advocacy Kenya increased its ART coverage tremendously with adults receiving it increasing from 70.4 % in the year 2009 to 85% in the year 2013. This intervention has however been facing challenge of adherence failure among the HIV infected patients necessitating need for an intervention to support adherence to medication for successful control and prevention of HIV-related mortality. Previous randomized trial in Kenya on tools for improved adherence reported increased self-reported adherence by 12%. Observational survey on accessibility, usage and perceptions of HIV infected patients towards internet and cell phones is still missing. A descriptive cross-sectional study was conducted at Kenyatta Nation Hospital with main objective to assess the accessibility, usage and perceptions of HIV infected patients towards internet and cell phones as tools for supporting adherence to medication. The data was collected using semi-structured questionnaires administered to HIV infected patients on treatment. Data was analysed using Statistical Package for the Social Sciences Version 16.0 for chi-squared test to establish Odds Ratios and 95% Confidence Interval for factors associated with cell phone and internet access and perceptions towards their use as a tools to support ARV adherence. This study was presented to Scientific Steering Committee and Ethical Review Committee at Kenya Medical Research Institute for Scientific and ethical approval respectively. Participants provided their consent by signing an informed consent form prior to their participation in the study. The main findings were 33% of participants with access to internet and 99% with access to cell phone. Majority of those with cell phone access used it for communication (49%) and money transactions (43%) while majority of those with internet access used it for communication via social networks (40%). Nearly all (99%) of the HIV infected clients interviewed supported the idea of cell phone use in improving adherence to their medication. Majority (98%) of the xviii respondents reported that internet was not a feasible tool in supporting ARV adherence due to its high cost of maintenance and use. The study concluded that there was higher accessibility of the participants to cell phone than internet and the high usage of cell phones for communication through calling and texting, while high usage of internet for communication through social media networks. Cell phone was identified as a feasible tool for supporting adherence to ARV therapy due to its affordability and easy access. The study therefore recommends adoption of cell phone into health care sector to boost medication adherence.