| FACILITATORS |
Taking/keeping control over his/her condition supports adherence
Maintaining routine/ regularity supports adherence; in turn, reminders may not be needed
Community groups would support adherence
Expertise of providers and having access to providers for questions (outside of clinic visits) could support adherence
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The digital platform can provide access to clinical data (VL, CD4)
Regular medical visits are a tiring routine for PLWH who would benefit from receiving data through a digital device
HIV is a stigmatized condition;technology can reduce the number of face-to-face visits to clinic, making the patient “invisible”—protecting their privacy and confidentiality
Digital platforms can promote closer relationships with providers and to protect the privacy of HIV patients
Secure digital networks can safeguard confidentiality
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Technology facilitated taking personal responsible for one’s health
Maintaining a daily routine promoted adherence
Social support promoted adherence
Counseling provided strategies to overcome barriers
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SMS/text message reminders promoted routine/regularity
The supervisory nature of the intervention promoted adherence
Adherence reports were generated by the system, which promoted positive patient-doctor relationship
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| BARRIERS |
Patients experienced stigma from providers and general public, which was a primary concern
Concerns regarding stigma prevented patients from disclosing HIV status to others
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Technology may result in a “passive” patient—one who is “controlled” by the technology device
Technology takes away from face-to-face exchanges and experiences with providers
Patients with unstable HIV may require face-to-face consultations to discuss treatment plan
Increased use of technology could lead to unintentional disclosure of health data
Patients do not trust security of cloud-based systems; systems unfortunately cannot repay a loss, like a bank can replace stolen funds
Real-time alerts may be intrusive to everyday life
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Barriers were primarily job related: forgetfulness, no breaks, concerns about inadvertent disclosure to coworkers, no private place to take medication
Stigma surrounding HIV was a concern
Alcohol and substance use interfered with adherence
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Cellphone alarms and alerts may be “annoying” when performing other tasks and activities
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