Assessing the Impact of Digital Communication Tools on Oral PrEP Adherence: A Systematic Review and Meta-analysis.

IF 2.4 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

AIDS and Behavior Pub Date : 2025-06-05 DOI:10.1007/s10461-025-04779-8

Julien Brisson, Dorothy Apedaile, Mariangela Castro-Arteaga, Amaya Perez-Brumer

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引用次数: 0

Abstract

This systematic review and meta-analysis evaluated the effect of digital communication tools (e.g., text message reminders) on improving daily oral HIV pre-exposure prophylaxis (PrEP) adherence. Searching PubMed, Embase, Web of Science, and PsychInfo, alongside clinical trial registries, we identified randomized controlled trials from 2012 to 2024 that compared digital interventions with standard care. The primary outcome of interest was PrEP adherence. From 975 studies reviewed, ten met our criteria, encompassing interventions on text messaging (n = 3), mobile applications (n = 6) and mobile games (n = 1). One study exclusively included cisgender women in Kenya. Nine studies focused on gay, bisexual, and other men who have sex with men (GBM)-four of these included transgender women (TW)-based in the USA (n = 8) and Thailand (n = 1). Studies measured PrEP adherence using tenofovir-diphosphate (TFV-DP) blood levels (n = 8), self-report (n = 1), and electronic bottle pill monitoring (n = 1). Utilizing a random-effects meta-analysis, we estimated pooled risk ratios (RR) for adequate PrEP adherence (TFV-DP levels ≥700 fmol/punch) at 12- and 24-weeks post-intervention. Due to differences in outcome measurement and timing, eight studies were pooled for the 12-week RR and seven for the 24-week RR. Those studies involved GBM and TW. At 12 weeks (n = 977), results showed a modest improvement in adherence (RR = 1.08, 95% CI: 1.02-1.14). There were no effects at 24 weeks (n = 562) (RR = 1.10, 95% CI 0.92-1.32). These findings suggest that digital communication tools had a limited impact on improving PrEP adherence. Further research is needed to develop sustained and diverse intervention strategies to support PrEP adherence.

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评估数字通信工具对口服PrEP依从性的影响：系统回顾和荟萃分析。

本系统综述和荟萃分析评估了数字通信工具（如短信提醒）对改善每日口服艾滋病毒暴露前预防（PrEP）依从性的影响。检索PubMed， Embase， Web of Science和PsychInfo，以及临床试验注册，我们确定了2012年至2024年的随机对照试验，将数字干预与标准护理进行比较。主要关注的结局是PrEP依从性。在975项研究中，有10项符合我们的标准，包括对短信（n = 3）、手机应用（n = 6）和手机游戏（n = 1）的干预。一项研究专门包括肯尼亚的顺性别妇女。9项研究集中在同性恋、双性恋和其他与男性发生性关系的男性（GBM）身上，其中4项研究包括美国（n = 8）和泰国（n = 1）的变性女性（TW）。研究使用替诺福韦-二磷酸（ttfv - dp）血液水平（n = 8）、自我报告（n = 1）和电子药瓶监测（n = 1）来测量PrEP的依从性。利用随机效应荟萃分析，我们估计了干预后12周和24周充分坚持PrEP （tv - dp水平≥700 fmol/punch）的合并风险比（RR）。由于结果测量和时间的差异，8项研究纳入了12周RR， 7项研究纳入了24周RR。这些研究涉及GBM和TW。在12周时（n = 977），结果显示依从性有适度改善（RR = 1.08, 95% CI: 1.02-1.14）。24周时无影响（n = 562）（RR = 1.10, 95% CI 0.92-1.32）。这些发现表明，数字通信工具对提高PrEP依从性的影响有限。需要进一步的研究来制定持续和多样化的干预策略，以支持PrEP依从性。

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来源期刊

AIDS and Behavior Multiple-

CiteScore

6.60

自引率

13.60%

发文量

382

期刊介绍： AIDS and Behavior provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews. provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews.5 Year Impact Factor: 2.965 (2008) Section ''SOCIAL SCIENCES, BIOMEDICAL'': Rank 5 of 29 Section ''PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH'': Rank 9 of 76