Feasibility of mHealth to Support Self-Management in Older Adults Living with HIV

TL;DR

This study shows that mobile health apps can help older adults manage HIV, especially those with emotional health challenges.

Contribution

Demonstrates mHealth feasibility for older adults living with HIV and identifies user engagement patterns.

Findings

Most participants used the mHealth app for over 24 days, showing high engagement.

Users with higher depression and stigma scores benefited more from the app.

The app was successfully installed and used independently by all participants.

Abstract

HIV infection is a chronic disease requiring lifelong management. Social stigma and healthcare discrimination limit access to health resources, making mobile health (mHealth) a promising intervention. However, concerns exist regarding the applicability of mHealth among older adults given potential barriers and engagement levels. This study assessed the feasibility of mHealth for older people living with HIV (PLWH). A one-arm, prospective, fully non-face-to-face mHealth trial was conducted with 24 PLWH aged ≥60 years. Participants used an mHealth app, “ESSC (Excellent Self-Supervised HIV Care),” which provided health-related information; allowed self-recording of medication adherence, mental diary, and sexual life; and enabled Q&A and comments interactions. After baseline assessments of demographics and HIV-related health, participants used the app for four weeks. Cumulative usage data were analyzed. All 24 participants were successful installing the app independently. Participant’s median age was 63.88 years (range: 60–82), and all were male. Based on usage, 7 participants (29.2%) were non-users (≤2 days), while 17 (70.8%) were users (≥24 days). Among users, the 28-day average included 33.6 daily medication logs, 14.2 mental diary entries, 7.6 sexual life records, 1.5 Q&A interactions, and 9.8 comments. Notably, users exhibited significantly higher baseline depression scores (6 vs. 0), higher stigma levels (8.7 vs. 7.0), and lower health-related quality of life (70 vs. 90) than non-users. This study demonstrated the feasibility of mHealth interventions for older PLWH. Findings suggest that mHealth adoption may be particularly beneficial for older PLWH with poorer emotional health, highlighting the need for targeted interventions to enhance usability.