Background: The exponential growth in the reach and development of new technologies over the past decade\nmeans that mobile technologies and social media play an increasingly important role in service delivery models to\nmaximise HIV testing and access to treatment and care. This systematic review examines the impact of electronic\nand mobile technologies in medical care (eHealth) in the linkage to and retention of priority populations in the HIV\ntreatment and care cascade, focussing on the Asia-Pacific region.\nMethods: The review was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses\n(PRISMA) statement from the Cochrane Collaboration guidelines. Both grey and published scientific literature from five\ndifferent databases were searched for all original articles in English published from 2010 to 2017. Studies conducted\noutside the Asia-Pacific region or not including HIV priority populations were excluded. The methodological quality of\nstudies included in the review was assessed using the Quality Assessment Tool for Quantitative Studies.\nResults: The database search identified 7309 records. Of the 224 peer-reviewed articles identified for full text review, 16\nstudies from seven countries met inclusion criteria. Six cross sectional studies found evidence to support the use of eHealth,\nvia text messages, instant messaging, social media and health promotion websites, to increase rates of HIV testing and\nre-testing among men who have sex with men (MSM). Evidence regarding the efficacy of eHealth interventions to improve\nantiretroviral treatment (ART) adherence was mixed, where one randomised controlled trial (RCT) showed significant benefit\nof weekly phone call reminders on improving ART adherence. Three further RCTs found that biofeedback eHealth\ninterventions that provided estimated ART plasma concentration levels, showed promising results for ART adherence.\nConclusions: This review found encouraging evidence about how eHealth can be used across the HIV treatment and\ncare cascade in the Asia-Pacific region, including increasing HIV testing and re-testing in priority populations as well as\nART adherence. eHealth interventions have an important role to play in the movement towards the end of AIDS,\nparticularly to target harder-to-reach HIV priority populations, such as MSM.
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