MAHILA: a protocol for evaluating a nurse-delivered mHealth intervention for women with HIV and psychosocial risk factors in India

Nancy R Reynolds, Veena Satyanarayana, Mona Duggal, Meiya Varghese, Lauren Liberti, Pushpendra Singh, Mohini Ranganathan, Sangchoon Jeon, Prabha S Chandra, Nancy R Reynolds, Veena Satyanarayana, Mona Duggal, Meiya Varghese, Lauren Liberti, Pushpendra Singh, Mohini Ranganathan, Sangchoon Jeon, Prabha S Chandra

Abstract

Background: Women living with HIV are vulnerable to a variety of psychosocial barriers that limit access and adherence to treatment. There is little evidence supporting interventions for improving access and treatment adherence among vulnerable groups of women in low- and middle-income countries. The M obile Phone-Based A pproach for H ealth I mprovement, L iteracy and A dherence (MAHILA) trial is assessing the feasibility, acceptability and preliminary efficacy of a novel, theory-guided mobile health intervention delivered by nurses for enhancing self-care and treatment adherence among HIV-infected women in India.

Methods/design: Women (n = 120) with HIV infection who screen positive for depressive symptoms and/or other psychosocial vulnerabilities are randomly assigned in equal numbers to one of two treatment arms: treatment as usual plus the mobile phone intervention (experimental group) or treatment as usual (control group). In addition to treatment as usual, the experimental group receives nurse-delivered self-care counselling via mobile phone at fixed intervals over 16 weeks. Outcome measures are collected at baseline and at 4, 12, 24 and 36 weeks post-baseline. Outcomes include antiretroviral treatment adherence, HIV-1 RNA, depressive symptoms, illness perceptions, internalized stigma and quality of life.

Discussion: The MAHILA trial will provide information about how a mobile health counselling intervention delivered by non specialist nurses may improve access to care and support the adherence and clinical outcomes of women with HIV infection living in low- and middle-income countries such as India.

Trial registration: NCT02319330 (First received: July 30, 2014; Last verified: January 2016).

Keywords: Antiretroviral adherence; HIV; LMIC; Mental health; Women; mHealth.

Figures

Fig. 1
Fig. 1
MAHILA flowchart

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