Mobile phone communication for improving uptake of antiretroviral therapy in HIV-infected pregnant women: updated systematic review and meta-analysis

Objective The aim of this systematic review is to provide some evidence on the use of mobile phone communication for improving ARV adherence during pregnancy, as well as to investigate whether text messaging on mobile phones could improve follow-up in HIV-exposed infants. Methods We did a systematic review and meta-analysis, using CENTRAL (Cochrane Central Register of Controlled Trials), Scopus, MEDLINE via PubMed, Web of Science, and CINAHL to search for studies in English published between 5 may 2016 to May 2021 that assessed the effects of mobile phone in HIV-infected pregnant women. We used MetaPro version 3.0 to compute the OR and RR and their 95%CI. We performed random-effects model meta-analysis for estimating pooled outcomes. Results Nine studies were included in the meta-analysis. The pooled maternal post-partum retention was (OR 2.20, 95%CI: 1.55 – 3.13, I 2 = 53.20%, P < 0.001). In the same line, the pooled odds of ART uptake was (OR 1.5, 95%CI: 1.07-2.11, I 2 =0%, P = 0.020) and we found statistically significant impact of mobile phone on HIV testing at 6 weeks and above among HIV exposed children (OR 1.89, 95%CI: 1.04 – 3. 48, I 2 = OR 1.89, 95%CI: 1.04 – 3. 48, I 2 =88.04%, P = 0.032). Conclusion In comparison to our previous review, this updated review focuses on moderate evidence for mobile phone communication in HIV-infected pregnant women. The results showed that using a mobile phone improved maternal post-partum retention, ART uptake, and infant HIV testing at 6 weeks and older.