Potential challenges with using mhealth interventions among medically underserved middle-aged women living with HIV

Background: Increasing numbers of consumers are using mobile technologies while others struggle to keep basic mobile phone services connected from month-to-month. We examined mobile phone ownership among HIV-positive women. Use and interest in mHealth intervention strategies (i.e., text, email, social media) were also explored.

Methods: Our study focused on cervical cancer prevention knowledge and screening behaviors among 145 urban and rural medically underserved HIV-positive women (90% black, mean age 45.2±10.7 years) recruited from Ryan White-funded clinics and community-based AIDS-service organizations in the southeastern United States. We also examined mobile phone ownership, email and social media use via self-administered, paper-and-pencil questionnaires. Follow-up focus group discussions explored interest in mHealth intervention strategies (i.e., text, email, social media).

Results: Most (75%) owned a mobile phone (45.5±10.5 years), of which 66% used only mobile phones (44.9±10.5 years) and 54% had pre-paid plans (46.1±10.3 years). Only 32% used email (42.0±11.7 years) and 26% used social media (42.5±10.9 years). Facebook (41.9±10.5 years) was used by 97% of social media users. Although our focus group data showed mixed receptivity to mHealth intervention strategies, age-appropriateness and trusted source of information were key themes that emerged.

Conclusions: mHealth interventions have been used successfully in HIV/AIDS prevention efforts. With the continued graying of the HIV epidemic, it will become increasingly important to reach an aging population with cost-effective mHealth interventions. Mixed receptivity among our study population of largely middle-aged HIV-positive women suggests more formative research is needed to inform the development of culturally-appropriate mHealth interventions strategies for this vulnerable group.