https://orcid.org/0000-0003-3315-6207
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ABSTRACT
Background
Adolescent girls and young women accounted for 25% of all new HIV infections despite representing only 10% of the population in Sub Saharan Africa. PEPFAR has launched the Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) initiative, a comprehensive HIV prevention program including PrEP services. Among adolescent girls and young women, PrEP adherence is currently sub-optimal. Tailored strategies for adolescent girls and young women to improve access and use of PrEP delivery are urgently needed to maximise its potential. Recommended interventions include peer-delivered interventions using mobile technology. However, data on the feasibility and acceptability of this approach is limited for SSA.
Objectives
We assessed the feasibility and perceived acceptability of providing mHealth peer-delivered interventions to support PrEP services among adolescent girls and young women in Botswana.
Methods
This cross-sectional study included HIV-negative women aged 18–24 years old seeking health services at DREAMS-supported facilities. Participants completed a survey assessing the feasibility and perceived acceptability of the mHealth peer-delivered interventions, which included the Acceptability of Intervention Measure (AIM). Descriptive analyses were performed.
Results
A total of 131 participated in the study. Overall, 89% owned a mobile phone (feasibility). There was no difference in cell phone ownership between participants from rural and urban settings. Among participants, 85% reported interest in participating in a mHealth peer-delivered intervention if it was available to them. Regarding perceived acceptability for mHealthpeer support groups for PrEP, the average score on the AIM was 3.8 out of 5 (SD = 0.8).
Conclusion
mHealthpeer-delivered interventions appear to be feasible and perceived acceptable among adolescent girls and young women in Botswana. This modality should be incorporated into PEPFAR’s programmatic toolkit of implementation strategies to improve PrEP services.
Responsible Editor Stig Wall
Responsible Editor Stig Wall
Acknowledgments
The authors gratefully acknowledge the participants for this study for their time. We also thank the data collectors of the survey.
Author’s contributions
MCL, LO, NB, NN, MEC contributed to the conception of the study. MCL, LO, NB, NN, MEC, AHN and KS contributed to the analysis and interpretation of the data and contributed to the drafting of the manuscript. All authors contributed to critically revising the manuscript and approved the final version.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Ethics and consent
The protocol was approved by the Botswana Ministry of Health- Health Research and Development Division Institutional Review Board (IRB) and the University of Maryland Baltimore IRB.
Paper context
PrEP is highly effective against HIV acquisition. Despite the availability of PrEP, most adolescent girls and young women) discontinued PrEP within the first month. Tailored interventions are urgently needed. Peer-delivered through mobile technology could enhance PrEP adherence. However, little is known about the acceptability and feasibility of this intervention in Botswana. Our findings suggest that peer-delivered intervention through mHealth is feasible and acceptable to adolescent girls and young women and should be evaluated to assess its impact.