JMIR Publications

ABSTRACT

Background:

Indigenous leaders continue to be concerned about high rates of HIV and barriers to HIV treatment among young Indigenous people involved in substance use. Growing evidence suggests that using mobile phones for health (mHealth) may be a powerful way to support connection with health services, including HIV prevention and treatment.

Objective:

This study examined patterns of mobile phone ownership and use among young Indigenous people who have used illicit drugs living with or vulnerable to HIV, and explored acceptability of an mHealth program to support access to healthcare in this population.

Methods:

The Cedar Project is a cohort study involving young Indigenous people who have used drugs in Vancouver and Prince George, British Columbia. This multi-method exploratory study involved 131 Cedar Project participants enrolled in our WelTel mHealth program. At enrollment, participants completed a questionnaire related to mobile phone use and interest in mHealth. Data was linked to the main Cedar Project questionnaires and serodata. We present comparative statistics (quantitative) and results of a rapid thematic analysis (qualitative) related to mobile phone patterns and interest in receiving an mHealth intervention.

Results:

Slightly less than half of participants (n=59; 45.4%) reported owning a phone. Among those with a phone, the majority owned a smart phone (n=46; 78%). Most participants with a phone reported having an unlimited texting plan (39; 70.9%); using Internet on their phone (n=44; 74.6%); and texting daily (n=51; 67.1%). A majority reported that using a mobile phone for health would be invaluable (n=120; 92.3%). There were no differences in mHealth acceptance between participants who already owned a phone and those who did not. All participants living with HIV felt using a mobile phone would be helpful for their health, while a small proportion of HIV-negative participants remained unsure (n=10; 12.5%). In response to open-ended questions asking why using a mobile phone may be helpful for health, participants identified a diverse set of anticipated benefits falling into six themes: (1) connection for emotional, mental and spiritual support; (2) connection to family; (3) staying in touch/being reachable; (4) overcoming current barriers to phone use; (5) convenience, privacy, and safety; and (6) access to healthcare and emergency services.

Conclusions:

We observed high acceptance and interest in using mobile phone technology for health despite low rates of personal mobile phone connectivity among young Indigenous people who have used drugs living with and vulnerable to HIV in British Columbia, Canada. Mobile phones were viewed as a way to support connections and relationships that are seen as critical to health and wellbeing among the young Indigenous people in this study. These findings may be useful for health providers preparing to scale up mHealth programs to support HIV prevention and treatment with this population.