# Brief communication: qualitative evaluation of call-for-life mHealth tool among youth living with HIV in Uganda

## TL;DR

This study evaluates a mobile health tool called C4L-IVR among HIV-positive youth in Uganda, finding it highly acceptable and helpful for improving treatment adherence and retention in care.

## Contribution

The study provides novel qualitative insights into the acceptability and impact of the C4L-IVR system on HIV treatment adherence among youth in rural Uganda.

## Key findings

- The C4L-IVR system was highly accepted by youth, with all participants rating it as comfortable to use.
- The system positively influenced behavioral skills and motivation for ART adherence and retention in care.
- Seven key themes emerged, including information, motivation, and barriers to adherence.

## Abstract

Afew studies have assessed the acceptability of mHealth interventions in youth living with HIV, Call For Life -Interactive Voice Response (C4L-IVR) system developed to support patients with HIV and TB in Uganda, specifically to improve treatment adherence and retention in care. This qualitative study examined the acceptability and usage of C4L-IVR, barriers and enablers of adherence and retention in care among youth living with HIV in rural Uganda.

Nested within a randomised intervention trial (NCT 04718974), this qualitative study examined youth 16–24 years old, through focus group discussions and indepth interviews at study end. Induction and deduction analysis was done with support of Nvivo software guided by the information motivation behavioral theory.

Between 9th December 2021 and 28th Apr 2022, 68 participants were recruited, with 38 (56%) females. We conducted 14 interviews 7 focused group discussions (FGD) (02 female only FGD; 5 mixed); and 7 in-depth interviews (IDI) (4 males and 3 females IDI. Seven main themes were identified: information received from the system, motivation from system calls, behavioural skills, barriers to adherence and retention, acceptability of the tool, experiences, and suggestions for improvement. All youth accepted the tool, scoring it highly comfortable on a 5 Likert scale, where 5 was “very comfortable” and 1 “not at all comfortable'.

The high acceptability and usage of C4L system along with impact on behavioral skills, this system had more enablers than barriers to ART adherence and retention in care.

The online version contains supplementary material available at 10.1186/s12981-025-00798-6.