WiseMama Zambia: Feasibility, Acceptability and Preliminary Effect of Wireless Technology to Improve Adherence to Antiretroviral Therapy in Pregnant and Postpartum Women
Antiretroviral therapy (ART) improves health and long-term survival of people living with HIV, but only if high adherence is maintained. Several studies have found perilously low ART adherence in pregnant and postpartum women (PPPW), the consequences which are dire: disease progression and death in women; HIV infection, death and orphanhood for babies; and a rise in drug resistant HIV. To improve ART adherence in PPPW, we will test the feasibility, acceptability, and preliminary effectiveness and cost-effectiveness of the use of wireless technology by PPPW and women's support networks in Zambia. Our integrated approach taps the potential of wireless technology to monitor adherence in real time and engages PPPW and their support networks to use the data generated to improve adherence. Women will use a pill container that wirelessly monitors adherence and automatically sends a text message reminder to women who fail to take a dose on time. Women's support groups will then use the monitoring data to provide follow up counseling and support. Demonstration of impact on adherence combined with cost data will enable us to evaluate the potential of this approach to help PPPW and all people living with HIV achieve the full life-saving benefits of ART. Our study will, for the first time, yield rigorous data on the effectiveness and cost-effectiveness of a novel ART adherence intervention that harnesses breakthrough wireless technology, women's empowerment, and community-based service delivery to achieve healthy outcomes for mothers and babies.