Abstract
BackgroundAs Internet and mobile phone use expands in India, there is an opportunity to develop mobile health (mHealth) interventions for marginalized populations, including men who have sex with men (MSM) and hijras (transgender women), hesitant to access traditional health care systems.ObjectiveThe purpose of this study was to determine if an mHealth intervention was acceptable to MSM and hijras living in Mumbai, and if so, what features would be useful in targeting the prevention of HIV acquisition and to increase the quality of life among persons living with HIV/AIDS.MethodsData from 4 focus groups with MSM and interviews with 4 hijras, 10 health service providers, and 8 mHealth developers were thematically analyzed.ResultsOnce the need for an mHealth intervention was confirmed, comments about features were organized into 3 themes: content, interface, and retention. Content subthemes included providing sex education for younger community members, providing information about STIs, and providing information and social support for persons living with HIV. Interface subthemes included presenting content using pictures; using videos to present stories of role models; using push notifications for testing, appointment, and medication reminders; using geolocation to link to just-in-time services; and using telemedicine to increase access to health service providers and community services. The 5 retention subthemes included keeping it fun, using gaming mechanics, developing content in regional languages, protecting confidentiality, and linking to social networking apps.ConclusionsThese findings may help inform mHealth development in India.
Highlights
The National AIDS Control Organization estimates the prevalence of HIV among adults in India as 0.3% [1]
Health service providers included medical doctors, nurses, mental health providers, and outreach workers who had a significant number of men who have sex with men (MSM) and hijra clients and who felt confident in their ability to speak about using technology to interact with patients. mobile health (mHealth) developers were recruited from an mHealth conference listserv
Three overarching themes emerged from the data that were relevant to the development of an mHealth HIV prevention intervention for Indian MSM: content, interface, and retention features of the intervention
Summary
The National AIDS Control Organization estimates the prevalence of HIV among adults in India as 0.3% [1]. Among men who have sex with men (MSM) and hijras (transgender women), the prevalence of HIV is estimated to be 4.3% and 7.5%, respectively [1,2]. Some evidence suggests interventions using mobile health (mHealth) technology may increase access to health care in developing countries such as India [8]. As Internet and mobile phone use expands in India, there is an opportunity to develop mobile health (mHealth) interventions for marginalized populations, including men who have sex with men (MSM) and hijras (transgender women), hesitant to access traditional health care systems. Interface subthemes included presenting content using pictures; using videos to present stories of role models; using push notifications for testing, appointment, and medication reminders; using geolocation to link to just-in-time services; and using telemedicine to increase access to health service providers and community services. Conclusions: These findings may help inform mHealth development in India
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