PREVALENCE AND CORRELATES OF MOBILE TECHNOLOGY ACCESS AND USE IN A COHORT OF YOUTH LIVING WITH HIV IN NAIROBI, KENYA

Abstract

ABSTRACT: In 2017, an estimated 36.9 million people were living with HIV/AIDS globally. Of the 1.8 million new HIV cases, 590,000 occurred among youth (15-24 years) and 250,000 among adolescents (15-19 years), leading to a growing number of youth living with HIV (YLWHIV) globally. Youth have unique HIV care needs that call for targeted interventions that resonate with young people to bridge the gap in youth HIV care. The growing popularity of phone technology and social media among young people provides a unique platform to deliver public health interventions for YLWHIV to support their Antiretroviral Treatment (ART) adherence and retention in care. OBJECTIVES: To characterize, among YLWHIV in Kenya, the prevalence of (1) access to Internet-enabled phones and (2) social media use for any purpose and for health support; and the correlates of (1) access to Internet-enabled phones and (2) use of social media. METHODS: A cross-sectional study was conducted using a questionnaire among 299 youth age 14-24 receiving HIV care from three hospitals in Nairobi, Kenya. Correlates of Internet-enabled phone access and social media use were evaluated by Poisson regression with robust standard errors. RESULTS: We found that 166 (55.5%) YLWHIV had Internet-Enabled-Phone (IEP) access and 151(91%) of those with IEP access used social media. Among the 151 (91%) participants who had IEP access and used social media, 30 (19.9%) reported participating in WhatsApp based support for health and 7 (4.6%) reported participating in Facebook-based group support for health. IEP access varied significantly by clinic site: 74% of youth recruited at Kenyatta National Hospital, the national referral hospital, had access to IEP, compared with 43.4% of youth recruited at Kayole II sub-district hospital and 49% at Mbagathi district hospital, both facilities serving informal settlements (PR 2.30, 95% CI 1.66-3.20, comparing KNH vs Kayole II, and PR 1.57, 1.08-2.28, comparing Mbagathi vs Kayole II). IEP access was also significantly higher among older youth: 66.9% among youth age 20-24 vs. 47.1% among adolescents age <20 (PR 1.67, 1.36-2.03). We identified no significant correlates associated with social media use within youth with IEP access. CONCLUSION: The majority of YLWHIV in Nairobi had access to IEP and used social media. Access was lower, but still substantial, among low-income youth living in informal settlements. Older youth had higher access than adolescents. These data support the hypothesis that internet and social media are platforms available to and used by YLWHIV, and may have potential for delivering interventions to support linkage and adherence to HIV care.