Feasibility and Preferences to Adopt mHealth-Based Interventions for HIV Prevention Among High-Risk Groups:...

Area of Science:

• Public Health
• Digital Health
• HIV Prevention

Background:

• HIV disproportionately impacts men who have sex with men (MSM), transgender individuals, and people who inject drugs in Pakistan, with 70.1% of cases linked to these key populations.
• Stigma and legal constraints exacerbate HIV risks within these vulnerable groups.
• Mobile health (mHealth) interventions present a potential avenue for enhanced HIV prevention, but their acceptability is not well understood.

Purpose of the Study:

• To assess the feasibility, willingness to use, and user preferences for mHealth interventions.
• To improve HIV knowledge, testing uptake, and risk behavior reduction among MSM, transgender individuals, and people who inject drugs in Pakistan.
• To explore the potential of digital health solutions in addressing HIV prevention challenges in vulnerable populations.

Main Methods:

• A cross-sectional survey was conducted with 210 participants (MSM, transgender individuals, and people who inject drugs) between February and May 2025.
• Participants were recruited using respondent-driven sampling and through community-based organizations and rehabilitation centers to ensure privacy.
• A self-administered questionnaire collected data on demographics, HIV knowledge, mobile technology use, mHealth acceptability, preferences, and risk behaviors.

Main Results:

• A high proportion of participants owned smartphones (76.7%) and had daily internet access (54.8%), with significant smartphone ownership associated with willingness to use mHealth apps (OR 4.14).
• 86.7% expressed willingness to use a clinic-integrated mHealth app for HIV prevention, preferring features like educational resources, medication reminders, e-consultation, and mental health support.
• Despite some HIV knowledge, many participants were unaware of their status, and high rates of vulnerability (drug use, violence, detention) and risky behaviors (transactional sex, multiple partners, low condom use) were reported.

Conclusions:

• mHealth interventions demonstrate high acceptability and significant potential for enhancing HIV prevention among key populations in Pakistan.
• Tailored, discreet mHealth platforms incorporating educational content, medication reminders, e-consultation, and mental health support are warranted.
• Addressing criminalization and ensuring user privacy are critical for successful mHealth intervention design and implementation.