Enhancing engagement in HIV care among adolescents and young adults

A focus on phone-based navigation and relationship building to address barriers in HIV care

Bibliographic Data

ID19593217
AuthorsHarriet Fridah Adhiambo (0000-0002-5323-5474, University of Washington, corresponding author), Clovis Mwamba (0000-0002-7626-6273, Centre for Infectious Disease Research in Zambia, corresponding author), Jayne Lewis-Kulzer (0000-0003-3314-9891, University of California, San Francisco, corresponding author), Sarah Iguna (0000-0001-9019-6032, Kenya Medical Research Institute, corresponding author), Gladys Moraa Ontuga (Kenya Medical Research Institute, corresponding author), Dorothy I Mangale (0000-0003-1264-405X, Washington University in St. Louis, corresponding author), Everlyne Nyandieka (Kenya Medical Research Institute, corresponding author), James Nyanga (Kenya Medical Research Institute, corresponding author), Isaya Opondo (Kenya Medical Research Institute, corresponding author), Joseph Osoro (Kenya Medical Research Institute, corresponding author), Lina Montoya (0000-0002-0975-4306, University of North Carolina at Chapel Hill, corresponding author), Edwin Nyagesoa (Kenya Medical Research Institute, corresponding author), Norton Sang (0000-0002-0092-7776, Kenya Medical Research Institute, corresponding author), Eliud Akama (0000-0003-1567-4756, University of Washington, corresponding author), Elizabeth A Bukusi (0000-0002-2031-2808, Kenya Medical Research Institute, corresponding author), Elizabeth Bukusi, L Abuogi (0000-0003-1492-5090, University of Colorado Denver, corresponding author), Elvin Geng (0000-0002-0825-1424, Washington University in St. Louis, corresponding author), Zachary Kwena (0000-0002-5117-5084, Kenya Medical Research Institute, corresponding author), Zachary Arochi Kwena
EditorsJulia Robinson (0000-0003-0719-3995)
Year2025
Volume5
Issue1
Pagese0002830
Publication date2025-01-09
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0002830
PMID39787184
OpenAlexW4406209729
LanguageEN
Citations received2
References cited56

Structural, psychological, and clinical barriers to HIV care engagement among adolescents and young adults living with HIV (AYAH) persist globally despite gains in HIV epidemic control. Phone-based peer navigation may provide critical peer support, increase delivery flexibility, and require fewer resources. Prior studies show that phone-based navigation and automated text messaging interventions improve HIV care engagement, adherence, and retention among AYAH. However, little is known about AYAH experiences utilizing electronic phone-based peer navigation and automated text messaging (E-NAV). We assessed the experiences of AYAH receiving phone-based peer navigation to address barriers to HIV care engagement and viral suppression. We purposefully selected participants randomized to E-NAV within the Adapt for Adolescents in Kisumu, Kenya, and conducted 20 in-depth interviews. Interviews were conducted by a trained qualitative researcher between October and December 2021 and explored topics such as health-seeking and care experiences, E-NAV acceptability and benefits, and the client-navigator relationship. The interviews were audio-recorded and transcribed. We then applied inductive and deductive coding, followed by thematic analysis. Overall, participants found E-NAV acceptable in regard to content and frequency–particularly the opportunity to select a preferred time for calls/text messages, including evenings and weekends. They found the tone of navigator calls and messages friendly, supporting relationship building. Further, AYAH-navigator relationships were described as fraternal, client-focused, and confidential, which supported a personal connection and trust. Reported E-NAV benefits included adherence and appointment reminders, increased knowledge about HIV care, and strategies to address HIV stigma. Electronic navigation is a promising method for youth peer navigation because it optimizes reach (both in time and space) for youth that have severe constraints on both while preserving the ability to create a rapport and a relationship with patients

Computer security · Confidentiality · Focus group · Internet privacy · Peer group · Peer support · Phone · Psychological intervention · Qualitative research · Thematic analysis · Computer Science · HIV/AIDS Research and Interventions · ICT in Developing Communities · Medicine · Mobile Health and mHealth Applications · Nursing · Psychology · Social Psychology