JMIR Publications

ABSTRACT

Background:

In East Africa (EA), where landlines are used by 1% of the population, and access to the internet is limited, owning a cell phone is rapidly becoming essential for acquiring information and resources. Our analysis illuminates the perils and potential promise of mobile phones with implications for future interventions to promote the health of adolescent and young adult (AYA) and prevent HIV infection.

Objective:

Our objective was to detail the current state of AYA phone usage in the region and trace out the implications for mobile health interventions.

Methods:

We identified 2 trading centers that were representative of southern Uganda in terms of key demographics, proportion of cell phone ownership, and community HIV prevalence. We stratified the sample of potential informants by age group (15-19, 20-24), gender, and phone ownership and randomly sampled 31 KII participants within these categories. In addition, we conducted 24 ethnographic participant observations among AYA in the communities of study.

Results:

AYA frequently reported barriers to using their phones such as difficulty accessing electricity. Nearly all AYA used mobile phones to participate in the local economy and communicate with sexual partners. Phone use was frequently a point of contention between sexual partners as well, with many AYA reporting that their sexual partners associated phone use with infidelity. Few AYA reported using their phones for health-related purposes, with most getting health information in person from health workers. However, most AYA reported that they would like to use their phones for health purposes, and specifically stated they would like to use their mobile phones to access current HIV prevention information. Finally, most participants reported an instance when they used their phone in an emergency, with childbirth related emergencies being most common.

Conclusions:

The current analysis demonstrates how mobile phones are related to income-generating practices in the region and communication with sexual partners, but not access to health and HIV information. Our analysis offers some explanation for our prior work that suggested an association between mobile phone ownership, having multiple sexual partners, and HIV risk. Mobile phones have untapped potential to serve as tools for health promotion and HIV prevention.