Team to test app for improving HIV care for new mothers in South Africa

South Africa has more HIV/AIDS patients than any other country and is home to the world's largest antiretroviral program. According to the World Bank, as of 2018 the prevalence of HIV among South Africans ages 15 to 49 was 20.4%. Nearly one in three pregnant women attending antenatal care in South Africa is living with HIV.

As South Africans with HIV move around the country, there is a risk they will disengage from the health care system or otherwise become lost to follow-up care.

To study and address this risk, Kate Clouse, Ph.D., MPH, assistant professor of Nursing and Medicine and part of the core faculty at the Vanderbilt Institute for Global Health, is working with researchers in South Africa and California on a randomized controlled trial of a smartphone app called CareConekta. Clouse devised CareConekta in collaboration with University of Cape Town researchers Tamsin Phillips, Ph.D., and Landon Myer, Ph.D., MBChB.

The app is designed to facilitate patient engagement with HIV care across the peripartum period, that is, shortly before, during and immediately after giving birth.

"This risk of South African HIV patients becoming lost to care is especially high for new mothers and their babies during the postpartum period. We're out to test whether combining the CareConekta app with text notifications, phone calls and WhatsApp messages can reduce this risk and improve patient outcomes. Along the way, we also hope to gain insight into patterns of HIV patient mobility in the peripartum period," Clouse said.

The three-year randomized trial will enroll 200 pregnant women receiving care at Gugulethu Midwife Obstetric Unit in Cape Town. The study data will include GPS location data gathered through CareConekta, participant responses to questionnaires, and post-study review of participant electronic and paper medical records.