How Mobile Health Can Change the Contexts of Living With HIV and Engaging With Treatment and Care in Iran

A Realist-Informed Qualitative Study

Dados Bibliográficos

ID4641089
AutoresVira Ameli (0000-0002-2403-442X, University of Oxford, autor correspondente), Geoff Wong (0000-0002-5384-4157, University of Oxford), Geoffrey Wong (University of Oxford), Jane Barlow (0000-0001-8418-4270, University of Oxford), Minoo Mohraz (0000-0001-7911-4382, Tehran University of Medical Sciences), Franziska Meinck (0000-0002-5234-3799, University of Edinburgh), Leila Taj (0000-0001-7537-964X, Tehran University of Medical Sciences), Tayebeh Amiri (Tehran University of Medical Sciences), Abbas Boosiraz (Tehran University of Medical Sciences), Lora Sabin (0000-0002-2782-542X, Boston University), Jessica E Haberer (0000-0001-5845-3190, Massachusetts General Hospital)
Ano2025
Volume35
Fascículo2
Páginas156-173
Data de publicação2025-02-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoQualitative Health Research (JOURNAL)
Identificadores do periódicoISSN: 1049-7323 • E-ISSN: 1552-7557
EditoraSAGE Publications Inc (PUBLISHER)
DOI10.1177/10497323241256865
PMID39106351
OpenAlexW4401355345
IdiomaEN
Referências citadas73

Mobile health (mHealth) interventions are increasingly used to address the challenges of living with HIV and engaging with antiretroviral therapy. A wealth of evidence supports the efficacy of mHealth in supporting living with HIV. Yet, there is a dearth of evidence on how mHealth improves outcomes, which features are effective, and why these work in a particular setting. This study uses stakeholder views, including patients, providers, peer supporters, counsellors, and program directors, to conceptualize how specific mHealth features could interact with contexts of living with HIV and mechanisms that shape engagement with treatment. The study is part of an ongoing research project on engagement with HIV care in Iran. We draw on the perspectives of recently diagnosed and more treatment-experienced patients and their providers, using purposive sampling, conducting 9 focus group discussions with a total of 66 participants, in addition to 17 interviews. Our findings suggest that mHealth designs that feature provider connection, proactive care, and privacy and personalization are expected to dilute the harsh contexts of living with HIV. We build on previously identified socioecological pathways that disrupt antiretroviral therapy in Iran and find that mHealth can enhance the relation between the health system and patients. Our findings suggest that personalized mHealth features and provisions can partially mitigate the compounded impacts of harsh socioecological pathways that impede treatment success in Iran. Our social constructivist study was augmented with realist-informed analysis and could have transferability to similar contexts that trigger similar mechanisms of treatment disruption

Business · Health care · mHealth · Personalization · Political science · Psychological intervention · Qualitative research · Sociology · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Mobile Health and mHealth Applications · Nursing · Psychology