Accepted for/Published in: JMIR Formative Research
Date Submitted: May 19, 2023
Open Peer Review Period: May 19, 2023 - Jul 14, 2023
Date Accepted: Oct 3, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited.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.
Facilitated WhatsApp support groups for youth living with HIV in Nairobi, Kenya: a single-arm pilot intervention study
ABSTRACT
Background:
Mobile technology can support HIV care, but studies in youth living with HIV (YLWH) are limited.
Objective:
We developed a facilitated WhatsApp group intervention (named Vijana-SMART) for YLWH, grounded in social support theory and guided by YLWH’s design recommendations. This paper evaluates the intervention’s acceptability and pre-post changes in health outcomes.
Methods:
YLWH participated in ~25-person interactive WhatsApp groups facilitated by study staff for 6 months. Study staff sent groups weekly structured messages and encouraged unstructured messaging. We conducted a single-arm pilot among 55 YLWH ages 14-24 recruited from a government healthcare facility serving a mixed income area of Nairobi, Kenya. At enrollment and follow-up, self-report questionnaires assessed acceptability, ART information, motivation, and behavioral skills (IMB), depression, social support, stigma, resilience, and ART adherence. All participants received the intervention. We used generalized estimating equations (GEE) clustered by participant to evaluate changes in scores from baseline to follow-up and levels and correlates of participant WhatsApp messaging.
Results:
Median age was 18 and 67% were female. Intervention acceptability was high: all participants reported it was helpful, and 73% sent ≥1 WhatsApp message. Messaging levels were higher during school holidays, earlier in the intervention, and among youth age ≥18. IMB scores increased from enrollment to follow-up (66.9% to 71.3%, p<0.001). Stigma scores also increased (8.3% to 16.7%, p=0.001) and resilience scores decreased (75.0% to 70.0%, p<0.001). We found no significant change in ART adherence, social support, or depression.
Conclusions:
Increased IMB scores following WhatsApp group participation may improve HIV outcomes. Increased stigma and decreased resilience may reflect transient unintended consequences of group sharing of challenging experiences, which should be addressed in larger randomized evaluations. WhatsApp groups present a promising and acceptable modality to deliver supportive interventions to YLWH beyond the clinic. Clinical Trial: This study was registered at clinicaltrials.gov (NCT05634265).
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.