Opportunities for technology-based HIV prevention among secondary students in cape town, South Africa

Background: Estimates suggest that if the current HIV infection rates remain stable in South Africa, 50% of 15-year-olds alive today will die from AIDS. The need to develop effective, scalable HIV programs for South African adolescents cannot be overstated.

Methods: In 2012, 1,107 8th–11th graders completed a paper-and-pencil survey. Respondents were enrolled in one of three public high schools located in lower income neighborhoods in Cape Town.

Results: Eighty-one percent of respondents have used text messaging (SMS) and 81% have gone online. If an HIV prevention program was offered online, 53% of youth would be somewhat or extremely likely to access it; slightly fewer (47%) felt the same about an SMS-based program. In comparison, 73% said they would be likely to access a program if it were offered at school. Email was the least endorsed delivery mechanism (38%). Interestingly, girls (52%) were more likely than boys (38%) to consider SMS-based delivery, but similar percentages were noted for Internet delivery (56% versus 55%, respectively). Slightly more youth who rated their likelihood of getting HIV to be above average were interested in Internet delivery (51%) compared to SMS (46%). Similar trends were noted among youth who were tired of hearing messages about HIV prevention.

Conclusions: Access to the Internet and SMS is high among low income adolescents attending high school in Cape Town. Internet programs may have the potential to reach slightly more youth than SMS programs. Given the preference for school-based programming, embedding the intervention within a school setting appears wise.