Developing a mHealth intervention to promote uptake of HIV testing among African communities in the UK: a qualitative study

Background: HIV-related mHealth interventions have demonstrable efficacy in supporting treatment adherence, although the evidence base for promoting HIV testing is inconclusive. Progress is constrained by a limited understanding of processes used to develop interventions and weak theoretical underpinnings. This paper describes a research project that informed the development of a theory-based mHealth intervention to promote HIV testing amongst city-dwelling African communities in the UK. Methods: A community-based participatory social marketing design was adopted. Six focus groups (48 participants in total) were undertaken and analysed using a thematic framework approach, guided by constructs from the Health Belief Model. Key themes were incorporated into a set of text messages, which were pre-tested and refined. Results: The focus groups identified a relatively low perception of HIV risk, especially amongst men, and a range of social and structural barriers to HIV testing. In terms of self-efficacy around HIV testing, respondents highlighted a need for communities and professionals to work together to build a context of trust through co-location in, and co-involvement of, local communities which would in turn enhance confidence in, and support for, HIV testing activities of health professionals. Findings suggested that messages should: avoid an exclusive focus on HIV, be tailored and personalised, come from a trusted source, allay fears and focus on support and health benefits. Conclusions: HIV remains a stigmatized and de-prioritized issue within African migrant communities in the UK, posing barriers to HIV testing initiatives. A community-based participatory social marketing design can be successfully used to develop a culturally appropriate text messaging HIV intervention. Key challenges involved turning community research recommendations into brief text messages of only 160 characters. The intervention needs to be evaluated in a randomized control trial. Future research should explore the application of the processes and methodologies described in this paper within other communities

Text messaging to encourage uptake of HIV testing amongst African communities: findings from a theory based feasibility study

Background: There is a public health need to tackle high levels of undiagnosed (or late diagnosed) HIV amongst the UK's African communities. This research aimed to assess the feasibility and acceptability of using a text messaging intervention to encourage uptake of HIV testing amongst this population in a UK city. Methods: Participatory research adopting a mixed-methods design. Four distinct stages included: [1] Formative Research: Six focus group discussions (FGDs) were conducted with diverse sections of the African community to assess perceptions about HIV and to inform message development (n=48). The Health Belief Model (HBM) was used as an organising framework for data analysis and interpretation. [2] Message Development: SMS messages were developed based on HBM constructs, existing HIV campaigns and FGD findings, and tailored according to language, gender and religion. 12 HIV-related and 12 generic health-related text messages were developed and piloted using elicitation interview processes. [3] Intervention and outcomes: 172 participants were recruited. They received 2 messages per week for 12 weeks. Data was collected in pre and post questionnaire surveys assessing uptake of HIV testing, HIV-related attitudes and knowledge and perceived general health. [4] Evaluation: Acceptability and meaningfulness of the intervention were explored via semi-structured telephone interviews (n=21). Data were analysed using thematic content analysis

Work with the community or go home: local engagement in Mozambique

A health intervention in a complex crisis, such as the one in Cabo Delgado, Mozambique, can only succeed if the community is effectively engaged and actively participates in the response

Mozambican adolescents and youths during the covid-19 pandemic: Knowledge and awareness gaps in the provinces of sofala and tete

(1) Background: Mozambique has an average population age of 17 years and adolescents and youths have a pivotal role in SARS-CoV-2 pandemic control. (2) Methods: We conducted a cross-sectional study in order to assess the awareness and information needs with regard to COVID-19 among a sample of adolescents and youths from two different Mozambican provinces. (3) Results: Only 25% of adolescents and youths had a high level of awareness and only 543/2170 participants reported a high level of knowledge regarding COVID-19. In our multivariate model, significant predictors of reporting a high level of knowledge about COVID-19 include female sex (O.R. = 1.47; 95% confidence interval (CI) 1.23\u20132.89), having a house without a thatched roof (O.R. = 1.85; 95% CI 1.02\u20132.95) and HIV-positive status (O.R. = 1.56; 95% CI 1.36\u20132.87). (4) Conclusions: Our study highlights an important and relevant knowledge gap in adolescents and youths with respect to the COVID-19 pandemic. Involving young people and adolescents in the fight against SARS-CoV-2 is an essential strategy, especially in countries where the national average age is young, such as Mozambique, and where this epidemic can aggravate an already fragile health system