Sophie Henry

Technology is changing our world — particularly, it is lending itself to solutions in medicine.

A recent clinical trial examined the use of a virtual counseling tool to prevent HIV and promote the health of patients who live with HIV/AIDS in East Africa and found the tool to be effective. Yale School of Nursing Dean Ann Kurth was the first author on the study, which tested a computer-based HIV counseling program in Kenya and was published in the journal AIDS Education and Prevention. The study aimed to find a low-cost solution that connected patients with support and counseling in places like Kenya that experience challenges like health worker shortages.

“So the situation is that there are about 38 million people living with HIV around the world, and only about 23 million of them are on treatment, which helps extends lives and reduces the risk of transmitting HIV to others,” Kurth said. “One of the things I focus on in my research is how to take a patient-centered approach and also recognize what the health system challenges are.”

In Kenya, the healthcare worker shortage makes it more difficult for patients with HIV to access treatment. The software used in the study, called CARE+ Kenya, offers a computer-based alternative to in-person counseling. In the study, 236 participants were monitored for nine months as they used the software to make a health plan, watch skill-building videos and do follow-up sessions when they revisited the clinic, among other actions.

Director of the Yale HIV/AIDS Program Merceditas Villanueva, who was not involved with the study, said health care worker shortages impact how effectively doctors can treat patients.

“When you have a workforce shortage, you need to have a mechanism of being able to target the people at greatest risk,” Villanueva said. “I think the avenues that are out there now to reach patients are really quite innovative.”

After the nine-month monitoring period, the study’s authors found that using CARE+ Kenya was associated with decreased HIV viral load in patients. The recent study headed by Kurth is the latest to suggest that the CARE+ virtual counseling tool can improve health outcomes.

“What that showed is that using the computer tool for those folks did help them actually do a better job with their medication and reduce the virus in their bloodstream,” Kurth said.

Despite the progress that has been made, Robert Bazell — an adjunct professor in the Department of Molecular, Cellular and Developmental Biology who covered the HIV/AIDS epidemic for 38 years as the chief science and health correspondent for NBC News — said that more work will need to be done to increase HIV prevention and education efforts.

“We really need to step up,” Bazell said. “There is a big danger that everybody thinks that this problem has been solved, but [HIV] still kills about one million people a year in the world, and that’s hardly a solved problem.”

According to the World Health Organization, there were an estimated 37.9 million people living with HIV/AIDS in 2018.

Julia Bialek | julia.bialek@yale.edu