Currently submitted to: JMIR mHealth and uHealth
Date Submitted: May 18, 2026
Open Peer Review Period: May 18, 2026 - Jul 13, 2026
(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Warning: This is an author submission that is not peer-reviewed or edited.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.
Acceptability and Usability of the HOPES+ AI Empathy Agent for Perceived Stigma Intervention Among Women Living With HIV/AIDS: A Pilot Mixed-Methods Study
ABSTRACT
Background:
The global HIV/AIDS epidemic persists, and women living with HIV/AIDS (WLWHA) experience substantial disease burden, social stigma, and discrimination, creating an urgent need for mental health support.
Objective:
This study evaluated the acceptability, usability, and real-world experience of the HOPES+ AI Empathy Agent among WLWHA, identified core intervention needs, and provided empirical evidence for AI empathy tool development in HIV mental health.
Methods:
A parallel convergent mixed-methods pilot study enrolled 41 WLWHA.. Quantitative assessments were conducted using records of task completion times and the Post-Study System Usability Questionnaire (PSSUQ); qualitative analysis was performed through semi-structured interviews and Colaizzi content analysis; and a comprehensive evaluation was conducted based on the ISO 9241-11 usability standards across three dimensions: effectiveness, efficiency, and subjective satisfaction.
Results:
Participants reported high acceptability and usability of the HOPES+ AI Empathy Agent, noting it effectively reduced perceived stigma. The primary barriers to use included cost concerns, privacy and data security worries, limited digital literacy, and a current lack of need for additional mental health support. Participants explicitly expressed a need for mental health services that are easily accessible, highly private, convenient, and available in minority languages.
Conclusions:
WLWHA have urgent mental health needs related to perceived stigma. The HOPES+ AI Empathy Agent is an acceptable, usable low‑barrier tool for stigma intervention, supporting broader implementation and optimization.
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