Abstract
Background
mHealth (mobile health) is a promising tool to deliver healthcare interventions to underserved populations. Across low- and middle-income countries (LMIC), the prevalence of smartphones has risen to 42%. Effective mHealth deployment in LMIC requires an understanding of how LMIC populations use mobile technology. We characterized the use of mobile devices in rural KwaZulu-Natal, South Africa to tailor mHealth interventions for people living with HIV and at risk for acquiring HIV.
Methods
We surveyed participants in community settings and offered free HIV counseling and testing. Participants self-reported their gender, age, relationship status, living distance from preferred clinic, receipt of monthly grant, condomless sex frequency, and circumcision status (if male). Outcomes included cell phone and smartphone ownership, private data access, health information seeking, and willingness to receive healthcare messages. We performed multivariable logistic regression to assess the relationship between demographic factors and outcomes.
Results
Among 788 individuals surveyed, the median age was 28 (IQR 22–40) years, 75% were male, and 86% owned personal cell phones, of which 43% were smartphones. The majority (59%) reported having condomless sex and most (59%) males reported being circumcised. Although only 10% used the phone to seek health information, 93% of cell phone owners were willing to receive healthcare messages. Being young, female, and in a relationship were associated with cell phone ownership. Smartphone owners were more likely to be young and female, less likely to live 10–30 minutes from preferred clinic, and less likely to receive a monthly grant. Those reporting condomless sex or lack of circumcision were significantly less likely to have private data access.
Conclusion
Most participants were willing to receive healthcare messages via phone, indicating that mHealth interventions may be feasible in rural KwaZulu-Natal. Smartphone-based mHealth interventions specifically geared to prevent or support the care of HIV in young women in KwaZulu-Natal may be feasible. mHealth interventions encouraging condom use and medical male circumcision should consider the use of non-smartphone SMS and be attuned to mobile data limitations.
Disclosures
All authors: No reported disclosures.
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