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Digital health technologies are revolutionizing healthcare delivery in Africa and across the globe. However, their impact on improving care for people living with HIV (PLHIV) in Africa has been relatively unexplored. The UNAIDS 95:95:95 targets face stark drawbacks from poor adherence to antiretroviral therapy (ART) and retention in care. Although digital tools have strengthened the HIV care cascade, particularly at the critical stages of initiation, adherence, and retention, their impact and synergistic potential remain uncertain. This review synthesized African evidence to assess the roles and impact of digital monitoring tools for improving ART adherence and retention among PLHIV in Africa. In addition, it summarizes potential facilitators and barriers to integrating these tools into the HIV care continuum in Africa. A literature search was conducted using PubMed, Google Scholar, Embase, and Cochrane Central. The websites of the World Health Organization (WHO) and the Joint United Nations Program on HIV/AIDS (UNAIDS) were also searched for additional data. The searches were restricted to studies published in English from January 2010 to November 2023. The review identified a significant trend towards utilizing mobile phones, SMS, and web-based applications for ART adherence and retention monitoring in Africa, where the use of mobile devices for periodic reminders and remote counseling has boosted HIV adherence in Nigeria, South Africa, and Uganda to about 75%. Novel interventions encompassing electronic pharmacy refill tracking, tele-counseling, and medication electronic monitoring systems such as smart pill containers have been utilized but with sparse usage. These tools have been invaluable in overcoming the barriers to antiretroviral adherence and retention, such as stigma, the digital divide, privacy concerns, and limited healthcare access. Collaboration between key stakeholders like local health professionals and multinationals is crucial to overcoming these barriers. Furthermore, exploring other potential facilitators, such as tailored intervention and community engagement, is vital for maximizing the impact of these technologies.
Ukoaka et al. (Wed,) studied this question.