Peer-reviewed article
Mobile phone access, willingness, and usage for HIV-related services among young adults living in informal urban settlements in Kenya: A cross-sectional analysis
Larissa Jennings Mayo‐Wilson, Bee‐Ah Kang, Muthoni A. Mathai, Margaret O. Mak’anyengo, Fred M. Ssewamala ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined mobile phone access and willingness to use mobile phones for HIV services among 350 young adults aged 18-22 living in informal settlements in Nairobi, Kenya. While over 80% had access to mobile phones with text messaging and internet capabilities, only 15% had ever used them to access HIV services. Young adults with individual phone ownership, education, and employment showed higher willingness to use mobile phones for HIV services, whereas females, those in large households, and those in partnerships were significantly less likely to have access or be willing to use such services.
Key points
- Mobile phone coverage was high (>80%) with text messaging and internet access, but only 15% of young adults had used phones to access HIV services
- Willingness to use mobile phones for HIV services was high overall (65%), but varied significantly by phone ownership type: 77% with individual access versus 18% with shared phones
- More educated (OR=1.84) and employed (OR=1.70) young adults were significantly more willing to use phones for HIV services
- Females (OR=0.29), those in partnerships/married (OR=0.30), and those living in large households (OR=0.47) had significantly lower odds of mobile phone access or willingness to use services
- Current usage of mobile phones for HIV services was low across all demographic groups, suggesting mHealth interventions are substantially under-utilized in this population
Limitations
This is a cross-sectional study that describes associations rather than causation, and it does not directly test the effectiveness of any mHealth intervention. The study cannot explain the underlying reasons why willingness is high but actual usage remains low, nor can it predict outcomes of mHealth interventions if barriers are addressed.
Abstract
BACKGROUND: Mobile phone-based health (mHealth) interventions have the potential to improve HIV outcomes for high-risk young adults living in informal urban settlements in Kenya. However, less is known regarding young adults' differential access to mobile phones and their willingness and use of mobile phone technologies to access HIV prevention, care, and treatment services. This is important as young adults make up the largest demographic segment of impoverished, informal urban settlements and are disproportionately impacted by HIV. METHODS: This study used observational survey data from 350 young adults, aged 18-22, who were living informal urban settlements in Nairobi, Kenya. Respondent driven sampling methods were used to recruit and enroll eligible youth. Using descriptive statistics and logistical regressions, we examined the prevalence of mobile phone access, willingness, and use for HIV services. We also assessed associated demographic characteristics in the odds of access, willingness, and use. RESULTS: The mean age of participants was 19 years (±1.3). 56% were male. Mobile phone coverage, including text messaging and mobile internet, was high (>80%), but only 15% of young adults had ever used mobile phones to access HIV services. Willingness was high (65%), especially among those who had individual phone access (77%) compared to lower willingness (18%) among those who shared a phone. More educated (OR = 1.84, 95 %CI:1.14-2.97) and employed (OR = 1.70, 95 %CI:1.02 = 2.83) young adults were also more willing to use phones for HIV services. In contrast, participants living in large households (OR = 0.47, 95 %CI:0.24-0.921), were religious minorities (OR = 0.56, 95 %CI:0.32-0.99), partnered/married (OR = 0.30, 95 %CI:0.10-0.91), or female (OR = 0.29, 95 %CI:0.16-0.55) were significantly less likely to have mobile phone access or usage, limiting their potential participation in HIV-related mHealth interventions. Given the low usage of mobile phones currently for HIV services, no differences in demographic characteristics were observed. CONCLUSION: Mobile health technologies may be under-utilized in HIV services for at-risk youth. Our findings highlight the importance of preliminary, formative research regarding population differences in access, willingness, and use of mobile phones for HIV services. More efforts are needed to ensure that mHealth interventions account for potential differences in preferences for mobile phone-based HIV interventions by gender, age, religion, education, and/or employment status.