Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Dec 31, 2019
Date Accepted: Jun 25, 2020
A Mobile Health Application for Self-Learning on HIV Prevention Knowledge and Services Among Young Indonesian Key Population: Cohort Study
ABSTRACT
Background:
Indonesia is the only country in the Asia Pacific region where HIV is still on the rise and its prevalence is extremely high among the key populations (KPs) men having sex with men, transgender, people who inject/use drugs. Mobile health application provides an innovative platform for delivering tailored HIV prevention and care among these populations more efficiently than possible through direct face-to-face approach.
Objective:
This study aimed to assess the role of a peer customized mobile application based on the principle of self- learning for improving HIV prevention knowledge and access to health services among the men having sex with men (MSM), Transgender (TG) women (known as waria in Indonesia), and people who use/inject drugs (PWUD) in Indonesia.
Methods:
A prospective interventional cohort study was conducted among the MSM, TG and PWUD in five provinces of Indonesia (Jakarata, West Java, East Java, Special Region of Yogyakarta and Bali). The study was evaluated using pre-post assessment survey. It was conducted on a sample of 200 unique users including 50 MSM and TG each and 100 PWUD with a follow-up response rate of 98% and 70%, respectively. An mHealth application named RUMAH SELA was developed and implemented among the KPs.
Results:
From baseline to end-line, there was a significant 1) increase in comprehensive HIV-related knowledge (percentage point changes of 24.5%, 34.7%, and 40% among MSM, TG, and PWUD; p<0.01); 2) reduction in condom-less sexual act (percentage point changes of 3.6%, 6.2%, and 11.4% (p<0.05) among MSM, TG, and PWUD, respectively; 3) uptake of HIV testing by 30.6%, 49% and 26% MSM, TG, and PWUD, respectively after using the application; 4) reduction in injecting drugs with used needle in PWUD (percentage point change of 42.9%); (5) increase in self-esteem (mean 26.4 vs 27.1; p=0.39, 26.5 vs 27.8; p=0.02, 24.0 vs 25.0;p=0.19) among MSM, TG, and PWUD, respectively). A quarter of MSM and TG, and 10.5% of PWUD had fixed the appointment for HIV test through the application. The application was quite accepted among the key populations as they felt they became confident in discussing issues about sexuality and most of the participants found the application user friendly.
Conclusions:
This one-of-kind mHealth intervention with mHealth application as a self-learning tool is effective in increasing HIV-related knowledge and behavior, and access to services with strong acceptability by the community. There is a need to scale up such interventions for efficacy testing in larger population to provide evidence for national level mHealth programs for addressing HIV.
Citation
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Copyright
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