Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 7, 2023
Date Accepted: May 24, 2024
Mobile Phones and HIV testing: Multi-country Instrumental Variable Analysis from Sub-Saharan Africa
ABSTRACT
Background:
Sub-Saharan Africa carries a disproportionate burden of HIV infections and AIDS-related diseases. In 2016, of the 6000 new HIV infections happening globally every day, two out of three occurred in sub-Saharan Africa. The uptake of new technologies could help reduce this burden. SSA has been a powerhouse of mobile phone technology adoption over the past decades, yet the impact that mobile phones had on reproductive health has not been a research priority.
Objective:
This study aims to fill this research gap by investigating the role of mobile phone connectivity on HIV testing in sub-Saharan Africa. We make use of the novel and comprehensive OpencellID cell tower database, and DHS geocoded information for over 400,000 women in 28 Sub-Saharan African countries.
Methods:
Through the use of OLS and IV regressions, We examine whether women’s community distance from the closest cell-tower influences knowledge about HIV testing facilities and the likelihood of ever been tested for HIV.
Results:
We find a negative and significant impact of distance on our main outcomes (0.7 and 0.5 percentage point decrease respectively for each kilometer away from a cell tower). We investigate the mechanisms through which such effects might occur to find that proximity to a cell tower increases HIV-related knowledge as well as reproductive health knowledge. Similar results are observed when the analysis is performed at community level.
Conclusions:
Results suggest that the effect of mobile phone connectivity is channelled through increased knowledge of HIV, STIs, and modern contraceptive methods. Further analysis shows that cell phone ownership has an even larger impact on HIV testing and knowledge. This paper adds to recent literature on the impact of mobile-based HIV prevention schemes by showing through large-scale analysis that better mobile network access is a powerful tool to spread reproductive health knowledge and increase HIV awareness.
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