MAHILA: a protocol for evaluating a nurse-delivered mHealth intervention for women with HIV and psychosocial risk factors in India

BMC Health Serv Res. 2016 Aug 4;16(a):352. doi: 10.1186/s12913-016-1605-1.


Background: Women living with HIV are vulnerable to a variety of psychosocial barriers that limit access and adherence to treatment. There is little evidence supporting interventions for improving access and treatment adherence among vulnerable groups of women in low- and middle-income countries. The M obile Phone-Based A pproach for H ealth I mprovement, L iteracy and A dherence (MAHILA) trial is assessing the feasibility, acceptability and preliminary efficacy of a novel, theory-guided mobile health intervention delivered by nurses for enhancing self-care and treatment adherence among HIV-infected women in India.

Methods/design: Women (n = 120) with HIV infection who screen positive for depressive symptoms and/or other psychosocial vulnerabilities are randomly assigned in equal numbers to one of two treatment arms: treatment as usual plus the mobile phone intervention (experimental group) or treatment as usual (control group). In addition to treatment as usual, the experimental group receives nurse-delivered self-care counselling via mobile phone at fixed intervals over 16 weeks. Outcome measures are collected at baseline and at 4, 12, 24 and 36 weeks post-baseline. Outcomes include antiretroviral treatment adherence, HIV-1 RNA, depressive symptoms, illness perceptions, internalized stigma and quality of life.

Discussion: The MAHILA trial will provide information about how a mobile health counselling intervention delivered by non specialist nurses may improve access to care and support the adherence and clinical outcomes of women with HIV infection living in low- and middle-income countries such as India.

Trial registration: NCT02319330 (First received: July 30, 2014; Last verified: January 2016).

Keywords: Antiretroviral adherence; HIV; LMIC; Mental health; Women; mHealth.

MeSH terms

  • Adult
  • Clinical Protocols
  • Delivery, Obstetric
  • Feasibility Studies
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / nursing*
  • HIV Infections / psychology*
  • HIV-1 / isolation & purification
  • Humans
  • India
  • Medication Adherence
  • Nursing Care / standards*
  • Outcome Assessment, Health Care
  • Pregnancy
  • Quality of Life
  • Risk Factors
  • Self Care
  • Social Stigma*
  • Telemedicine*

Associated data