Usage patterns and health outcomes of mHealth intervention for people living with HIV: a quasi-experimental study

Mobile health (mHealth) tools are increasingly used by people living with HIV (PLWH) to support self-management; however, how different engagement patterns influence health outcomes remains unclear. We conducted a single-arm, quasi-experimental study among 261 PLWH recruited from infectious disease clinics and HIV-related community organizations to evaluate a mobile app designed for health self-management. Participants used the app for four weeks, which included medication tracking, access to health information, journaling on mental and sexual health, and interactive Q&A functions. Latent profile analysis identified three user groups: Basic (60.5%), Knowledge (11.5%), and Active (28.0%) users. Basic users primarily tracked medications, whereas Knowledge users mainly viewed informational content. Active users engaged across features, particularly by journaling about mental and sexual health nearly daily or every other day. Compared with other groups, Active users demonstrated significant improvements in health-related quality of life and eHealth literacy. Frequent self-reflective journaling and attention to sexual well-being were associated with higher engagement and greater improvements in outcomes. Understanding which app features drive user engagement and health benefits can inform optimization of mHealth interventions for PLWH. For those who are adherent to treatment, journaling about emotional and sexual health may enhance quality of life and digital health literacy.