The 4 Youth By Youth mHealth Photo Verification App for HIV Self-testing in Nigeria: Qualitative Analysis of User Experiences

Abstract

Background Despite the global expansion of HIV self-testing (HIVST), many research studies still rely on self-reported outcomes. New HIVST verification methods are needed, especially in resource-limited settings. Objective This study aims to evaluate the user experience of a mobile health (mHealth) app to enhance HIVST result reporting and verification. Methods Semistructured, in-depth interviews were used to evaluate the user experience of the 4 Youth By Youth mHealth photo verification app for HIVST. We used a think-aloud approach, and participants performed usability tasks and completed a qualitative exit interview. The app included HIV educational resources, step-by-step video instructions for performing HIVST, a 20-minute timer, a guide on interpreting results with linkages to care, an offline version, and a photo verification system. Demographic characteristics were reported by using descriptive statistics. Qualitative data were analyzed by using thematic analysis. Results A total of 19 users—12 women and 7 men—with a mean age of 22 years, participated in the study. The users completed the usability tasks and successfully uploaded a photo of their test results by using the app without assistance. Four main themes were identified in the data. First, in terms of user-friendly design, the participants noted the user-friendly features of the offline version and the app’s low data use. However, some wanted the app to work in the background when using their mobile phone, and the font used should be more youth friendly. Second, in terms of ease of use, participants remarked that the app’s self-explanatory nature and instructions that guided them on how to use the app enhanced its use. Third, in terms of a user’s privacy, many participants reinforced the importance of privacy settings and tools that protect confidentiality among users. Finally, in terms of linkage to care, participants noted that the app’s linkage to care features were useful, particularly in relation to referrals to trained counselors upon the completion of the test. All the participants noted that the app provided a convenient and private means of verifying the HIV test results. Conclusions Our findings demonstrated the importance of engaging end users in the development phase of health technology innovations that serve youth. Clinical trials are needed to determine the efficacy of using an mHealth app to verify HIVST results among young people.

Assessing the Impact of use of HIV self-testing on the incidence of HIV Infection in Nigeria: a systematic review and meta-analysis

“…12. Rosenberg, 2021 [30] Strategies for enhancing uptake of HIV selftesting among Nigerian youths: a descriptive Study Design -Do not meet specific design criteria set out for the review analysis of the 4YouthByYouth crowdsourcing contest 13. Stacey, 2022 [31] Understanding factors that promote uptake of HIV self-testing among young people in Nigeria: Framing youth narratives using the PEN-3 cultural model.…”

An Unstructured Supplementary Service Data System to Verify HIV Self-Testing Among Nigerian Youths: Mixed Methods Analysis of Usability and Feasibility

“…mHealth intervention has become common in Nigeria because the high HIV burden among AYAs requires innovative youth-centered implementation strategies. For example, implementation strategies to promote HIV self-testing have significantly improved access to HIVST services in Nigeria [ 12 - 14 ].…”

“…However, a significant proportion of Nigerian AYAs have analog phones and low bandwidth [ 14 ]. Therefore, mHealth strategies are needed to promote HIVST among AYAs without smartphone access.…”

“…The existing mHealth literature focuses on high-income countries and centers on the perspective of people with higher electronic device bandwidth [ 14 ]. Additionally, the USSD platform has been used in Africa to address some SRH issues, but to the best of our knowledge, no studies have used USSD to verify HIVST results, thereby promoting its uptake.…”

The Impact of Technology on Adolescent Sexual and Reproductive Needs

“…WhatsApp was used to deliver the mHealth peer supported intervention, Interactive transition support for 15 to 19 year-old adolescents living with perinatally acquired HIV (InTSHA) in South Africa [ 14 ]. The 4 Youth by Youth mHealth photo verification app for self-texting was found to be feasible by Nigerian youth [ 15 ]. Text messaging was recommended to provide family planning information to adolescent and young adult women in Sierra Leone [ 16 ].…”