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AIDS Care. 2017 Jul;29(7):870-875. doi: 10.1080/09540121.2017.1286288. Epub 2017 Feb 3.

A qualitative study of Thai HIV-positive young men who have sex with men and transgender women demonstrates the need for eHealth interventions to optimize the HIV care continuum.

Author information

1
a The Thai Red Cross AIDS Research Centre , Bangkok , Thailand.
2
b SEARCH, The Thai Red Cross AIDS Research Centre , Bangkok , Thailand.
3
c HIV-NAT, The Thai Red Cross AIDS Research Centre , Bangkok , Thailand.
4
d The Kirby Institute, University of New South Wales , Sydney , Australia.
5
e Department of Global Health, Academic Medical Center , Amsterdam Institute for Global Health and Development, University of Amsterdam , Amsterdam , The Netherlands.
6
f Department of Health Behavior, Gillings School of Global Public Health , University of North Carolina , Chapel Hill , NC , USA.
7
g Division of Infectious Diseases, School of Medicine , University of North Carolina , Chapel Hill , NC , USA.
8
h US Military HIV Research Program , Walter Reed Army Institute of Research , Silver Spring , MD , USA.
9
i Henry M. Jackson Foundation for the Advancement of Military Medicine , Bethesda , MD , USA.

Abstract

In Thailand, young men who have sex with men (YMSM) and transgender women (TG) are disproportionately affected by HIV and have suboptimal care continuum outcomes. Although Thai YMSM and young TG are early adopters of emerging technologies and have high Internet and technology access and utilization, the potential of technology has not been harnessed to optimize the HIV treatment cascade. We interviewed 18 behaviorally HIV-infected YMSM and young TG regarding care challenges, identified how eHealth could address care needs, and elicited preferences for eHealth interventions. Participants reported struggling with individual and societal-level stigma which negatively impacted linkage to and retention in care, and antiretroviral therapy adherence. YMSM and young TG described inadequate in-person support services and heavily relied on random online resources to fill information and support gaps, but sometimes viewed them as untrustworthy or inconsistent. Participants universally endorsed the development of eHealth resources and proposed how they could ameliorate individual-level fears over stigma and improve public perceptions about HIV. Personalized and integrated eHealth interventions with interactive, user-driven structures, credible content, rewards for engagement, real-time counseling and reminder support could help overcome barriers YMSM and young TG face in traditional HIV healthcare systems and have the potential to improve care outcomes.

KEYWORDS:

Barriers to care; HIV care continuum; Thailand; eHealth; transgender women (TG); young men who have sex with men (YMSM)

PMID:
28158952
DOI:
10.1080/09540121.2017.1286288
[Indexed for MEDLINE]

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