JMIR Publications

ABSTRACT

Background:

Women living with HIV (WLWH) in the Southern United States, or South, face persistent and overlapping challenges to care engagement and antiretroviral therapy adherence, including HIV-related stigma, poverty, and inequitable access to healthcare. While mobile health (mHealth) interventions show promise for enhancing self-management and care engagement among people living with HIV, interventions tailored to WLWH remain limited, particularly those developed through participatory approaches that center their lived experiences.

Objective:

This study sought to evaluate the acceptability, comprehensibility, and personal relevance of targeted health messages developed for a proposed mHealth application tailored to WLWH in the South. Additionally, it explored participants’ perceptions of the feasibility and desirability of the proposed intervention.

Methods:

This study represents Phase 3 of a multi-stage, mixed-methods project. Message content was informed by earlier phases, which included individual interviews, surveys, perceptual mapping with WLWH, and input from a Community/Clinician Advisory Board. In this phase, three focus groups (two virtual, one in-person) were conducted with 30 WLWH recruited from Southern HIV clinics and community organizations. Participants reviewed prototype wireframes and health messages, including SMS-style content, and provided feedback on all content. Data were analyzed using conventional content analysis.

Results:

Participants expressed strong interest in the proposed mHealth app and emphasized the importance of health messaging that is clear, supportive, and personally meaningful. Four key categories emerged: (1) acceptability of a tailored mHealth app, with participants noting the value of privacy, accessibility, and convenience; (2) acceptability of message content, including preferences for affirming, uplifting language and images; (3) personal relevance, particularly for messages addressing stigma, spirituality, family, and empowerment; and (4) comprehensibility, highlighting the need for plain language and visual clarity.

Conclusions:

These findings support the development of a tailored mHealth intervention for WLWH in the South. Co-designed messages that center affirmation, spirituality, and real-life challenges were perceived as acceptable, comprehensible, and highly relevant. Future work will focus on refining the content and prototype testing.