Acceptability of a web-based virtual nursing intervention for Canadian women living with HIV on antiretroviral therapy: a mixed methods study

Adherence to antiretroviral therapy (ART) is essential for improving the health of women living with HIV (WLHIV), reducing maternal mortality, and preventing vertical transmission. However, WLHIV face many challenges, including medication side effects and impediments to therapy use. The aim of this study was to assess the acceptability of TAVIE-Woman, a web-based virtual nursing intervention for developing self-management skills to enhance ART adherence among WLHIV. Convergent mixed method research design was used. The quantitative component, a single-group post-test with 18 WLHIV recruited from two Canadian university hospitals, measured the intervention’s acceptability on the Web-Based Nursing Intervention Acceptability Scale. In the descriptive qualitative component, 17 semi-structured interviews were conducted to explore participant’s perception of information technology skills and intervention accessibility, overall impression of intervention, usefulness of intervention content and process, and improvement suggestions. Mean age of participants was 41.5 years, 56% were migrants, 44% were Canadian born, 72% were college or university graduates, 50% reported annual income under C$15,000, and 50% were unemployed. They had been on ART for a mean of 14 years and had a self-reported adherence level of 95%. Acceptability of TAVIE-Woman proved good. On the 5-point acceptability scale, all dimensions scored high, from 4.00 to 4.65, including motivational appeal, ease of understanding, dosage, ease of navigation, credibility of messenger, nurse interaction, user interface design, and individual relevance. Information tailoring received a moderate score. Five themes were identified from the qualitative data: who might benefit most from the intervention and when in the health trajectory, navigating the technology facilitated by human support, virtual nurse as intervention messenger, fit between on-screen representations and women’s reality, and perceived benefits. TAVIE-Woman shows promise in reinforcing ART self-management among WLHIV. Its acceptability rests on clarity of content, perceived credibility of virtual nurse, and human support. However, adjustments were suggested to improve perceived message personalization, notably by adapting content to the user’s life context. These results support the development of more inclusive digital interventions adapted to the varied trajectories of WLHIV and the transferability of these interventions to other contexts.