Acceptability, Needs, Concerns, and Barriers to Digital-Based Interventions for the Prevention of Mother-to-Child Transmission of HIV: Systematic Review and Qualitative Meta-Aggregation.

Background: Digital-based interventions have the potential to support initiatives for the prevention of mother-to-child HIV transmission (PMTCT). Nevertheless, reviews to explore experiences and perspectives toward digital-based interventions in mothers living with HIV remain limited. Objective: The aim of the study was to explore the experiences and perspectives toward digital-based interventions in promoting PMTCT services in mothers living with HIV. Methods: This study conducted a systematic review and qualitative meta-aggregation and adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) and the Joanna Briggs Institute (JBI) Reviewer's Manual. Electronic databases such as Scopus, PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Wiley Online Library were systematically searched on July 5, 2024. The eligibility criteria included qualitative studies that focus on mothers living with HIV and health care providers, exploring their experiences and attitudes toward digital-based interventions for the PMTCT of HIV. The quality of the studies was assessed using the JBI Critical Appraisal tools for qualitative research and the Mixed Methods Appraisal Tool (MMAT) for mixed methods studies. The meta-aggregation was used to synthesize findings from included qualitative studies. Results: The 8 included studies (3 qualitative and 5 mixed-methods studies) were conducted in Kenya, South Africa, and India and evaluated mobile-based interventions such as SMS, phone calls, and mobile apps. The findings were synthesized into overarching themes: (1) positive acceptability of digital-based intervention for PMTCT services; (2) the need for integrating education, support systems, and reminders into digital-based intervention among mothers living with HIV; (3) concerns about confidentiality; and (4) personal, interpersonal, and health care-related barriers to care adherence. These themes were divided into 9 categories, including perceived satisfaction, improved adherence, the need for education, support systems, reminders, concerns about their privacy, lack of family support, financial constraints, and negative provider attitudes. Conclusions: Although most included studies were limited, their findings highlight the insight that the integration of digital-based interventions is perceived as acceptable and beneficial in strengthening PMTCT services delivery among mothers living with HIV. Mobile-based tools were valued for delivering education and reminders and facilitating communication with providers. However, concerns about confidentiality and persistent structural barriers must be addressed. To strengthen PMTCT services, it is essential to integrate user-centered digital tools into maternal care, supported by policies that ensure data privacy and equitable access.