Currently submitted to: JMIR mHealth and uHealth
Date Submitted: Mar 19, 2025
Open Peer Review Period: Mar 21, 2025 - May 16, 2025
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Mobile phone access, usage patterns and perceptions of adolescents living with HIV on the use of gamified interventions to improve ART adherence in Eswatini: Qualitative study
ABSTRACT
Background:
Adolescents living with HIV (ALHIV) often experience poor anti-retroviral therapy (ART) outcomes due to multiple barriers affecting medication adherence. Effective self-care interventions are needed to address these challenges. Mobile phones are widely used by the adolescent population, thus present an opportunity to be used as a tool to enhance ART adherence using mobile phones as a targeted intervention. However, research on ALHIV's mobile phone access, usage patterns, and perceptions of mobile phone-based interventions is limited in Eswatini.
Objective:
This study explored the mobile phone access, usage patterns, and perceptions of mobile phone-based interventions among ALHIV in Eswatini to inform effective mobile health strategies for enhancing ART adherence among ALHIV.
Methods:
We conducted a qualitative study using in-depth interviews in the month of December 2023. A total of 29 ALHIV aged 10 to 19 years and enrolled on ART were purposively sampled were interviewed from five Teen Clubs in the Hhohho region in Eswatini. Topic areas covered were “mobile phone accessibility, usage patterns, and perceptions on the use of mobile phones to facilitate ART adherence.”
Results:
The study findings indicated high mobile phone access among participants, with primary usage focused on making and receiving calls, as well as engaging with social media. Three themes emerged regarding the use of gamified interventions to support ART adherence. Firstly, the use of gamified interventions aimed at ART adherence among ALHIV was deemed feasible, based on mobile phone access and past experiences with mobile game. Secondly, three main qualities of successful gamified interventions were identified as: being supportive, educational, and ensuring privacy in the design of the game. Lastly, confidentiality and mobile phone access factors were highlighted as potential concerns when designing gamified ART adherence interventions.
Conclusions:
The findings suggest potentially high access and usage of mobile phones among ALHIV on ART in Eswatini. This provides an opportunity to leverage mobile technology to enhance ART adherence through gamified interventions. However, it is essential to carefully consider ALHIV-specific needs and concerns in the design of these interventions to ensure their successful uptake and sustainability.
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