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Background <p>Maintaining high levels of medication adherence is essential for the success of antiretroviral therapy (ART), yet non-adherence remains a persistent challenge in resource-limited settings. Smart Pillboxes (SPBs) offer a promising digital solution by providing real-time adherence monitoring and clinical decision support. However, the successful implementation of these tools among people living with HIV (PLHIV) depends on understanding user-level barriers. This study examines the sociodemographic, behavioral, and infrastructural factors that influence the willingness to adopt SPBs among people living with HIV in Cameroon.</p> Methods <p>This cross-sectional study involved 153 PLHIV recruited from clinical sites in the Center Region of Cameroon. The Diffusion of Innovations (DOI) framework informed the conceptual categorization. Due to convergence issues with log-binomial models, statistical analyses utilized multivariable modified Poisson regressions with robust standard errors to identify predictors of adoption intent. Global model significance was assessed via the Wald Chi-square test. A bootstrap procedure was applied to validate the stability of identified predictors.</p> Results <p>At the outset, 60.8% of participants self-classified as adopters. Females were the majority (53%), and over half of the participants were single (55.6%). The final multivariable model demonstrated high statistical significance (Wald <InlineEquation ID="IEq1"> <EquationSource Format="TEX">\(\:{\chi\:}^{2}\)</EquationSource> </InlineEquation> = 29.5, <i>p</i> = 0.0019). Higher educational attainment (MA; aRR = 1.64, <i>p</i> = 0.004) and frequent medication forgetfulness (aRR = 1.35, <i>p</i> = 0.026) were identified as robust facilitators of adoption willingness. Adoption intent was significantly attenuated by the use of phone reminders (aRR = 0.77, <i>p</i> = 0.049) and unemployment (aRR = 0.64, <i>p</i> = 0.049).</p> Conclusion <p>Adoption intent of SPBs is driven by a synergy of socioeconomic status and felt behavioral needs. While infrastructure is a necessary baseline, educational attainment and perceived utility are the primary determinants of adoption intent in this urban population.</p>

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Predictors of smart pillboxes adoption intent among people living with HIV in Cameroon: a cross-sectional study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月10日

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  • Armel F. Setubi,
  • Bryan Shaw,
  • Katherine Robsky,
  • Ignace Gashongore,
  • Michael Ochieng Otieno,
  • Vinie Kouamou,
  • Xavier Gabriel Fopokam,
  • Rhonda BeLue,
  • Joy Musa Shallangwa,
  • Deus Bazira,
  • Christian J. Hunter

摘要

Background

Maintaining high levels of medication adherence is essential for the success of antiretroviral therapy (ART), yet non-adherence remains a persistent challenge in resource-limited settings. Smart Pillboxes (SPBs) offer a promising digital solution by providing real-time adherence monitoring and clinical decision support. However, the successful implementation of these tools among people living with HIV (PLHIV) depends on understanding user-level barriers. This study examines the sociodemographic, behavioral, and infrastructural factors that influence the willingness to adopt SPBs among people living with HIV in Cameroon.

Methods

This cross-sectional study involved 153 PLHIV recruited from clinical sites in the Center Region of Cameroon. The Diffusion of Innovations (DOI) framework informed the conceptual categorization. Due to convergence issues with log-binomial models, statistical analyses utilized multivariable modified Poisson regressions with robust standard errors to identify predictors of adoption intent. Global model significance was assessed via the Wald Chi-square test. A bootstrap procedure was applied to validate the stability of identified predictors.

Results

At the outset, 60.8% of participants self-classified as adopters. Females were the majority (53%), and over half of the participants were single (55.6%). The final multivariable model demonstrated high statistical significance (Wald \(\:{\chi\:}^{2}\) = 29.5, p = 0.0019). Higher educational attainment (MA; aRR = 1.64, p = 0.004) and frequent medication forgetfulness (aRR = 1.35, p = 0.026) were identified as robust facilitators of adoption willingness. Adoption intent was significantly attenuated by the use of phone reminders (aRR = 0.77, p = 0.049) and unemployment (aRR = 0.64, p = 0.049).

Conclusion

Adoption intent of SPBs is driven by a synergy of socioeconomic status and felt behavioral needs. While infrastructure is a necessary baseline, educational attainment and perceived utility are the primary determinants of adoption intent in this urban population.