Browsing by Author "Metta, Emmy"

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    Acceptability of an mHealth intervention to promote the use of pre-exposure prophylaxis among individuals at increased risk of HIV. The case of the Jichunge smartphone app in Dar es Salaam, Tanzania.
    (IAS, 2022-07-29) Mbotwa, Christopher; Kazaura, Method; Moen, Kåre; Leshabari, Melkizedeck; Metta, Emmy; Mmbaga, Elia J.
    Background: Reducing HIV infection rates among at-risk populations is more likely to contribute to achieving the 2030 goal of ending the epidemic. Countries in sub-Saharan Africa, including Tanzania, have started rolling out pre-exposure prophylaxis (PrEP), but adherence to the daily pills poses a challenge. Evidence indicates that mHealth is a promising solution for promoting uptake, retention, and adherence to PrEP. However, evaluation data of its implementation in Africa settings are scarce. This study aimed at assessing acceptability and initial use of mHealth in promoting PrEP use among female sex workers (FSW) and men who have sex with men (MSM) in Dar es Salaam, Tanzania. Methods: FSW and MSM residing in Dar es Salaam who owned smartphones and were eligible for PrEP were recruited using respondent-driven sampling and provided with the Jichunge, a smartphone-based application designed to promote adherence to PrEP and retention in PrEP services. The app offers users information about HIV and PrEP, reminds them to take their daily pill, allows them to consult a doctor and peer educator, and includes an online forum where may engage in discussions with other PrEP users. Results: A total of 885 participants (470 FSW and 415 MSM) with a median age of 26 and 21 years, respectively, were recruited. Most (559; 63.2%) opened the app and registered pill-taking (523; 59.1%) at least once. About a third of the participants accessed the app’s PrEP and HIV editorial contents (348; 39.3%) and participated in the discussion forum (277; 31.3%). A total of 172(19.4%) consulted a doctor or peer educator via the app. FSW were significantly more likely than MSM to open the app (FSW:74%; MSM: 50.8%; p<0.001), register daily pill use (FSW:71.7%; MSM: 44.8%; p<0.001), access editorial contents (FSW:47.0%; MSM: 30.6%; p<0.001), and engage in the discussion forum (FSW:34.3%; MSM: 27.9%; p=0.044). Online consultation was not statistically significant different between the two populations (FSW:20.1%; MSM: 18.1%; p=0.336). Conclusion: The use of different services of Jichunge was significantly high. This suggests that mHealth is acceptable and can be a valuable platform to promote the use of PrEP and other services among HIV at-risk populations in Tanzania.
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    Predictors of mHealth use in promoting adherence to pre-exposure prophylaxis among female sex workers: an evaluation of the Jichunge intervention in Dar es Salaam, Tanzania
    (Springer Nature, 2021-07-04) Mbotwa, Christopher; Kazaura, Method; Moen, Kåre; Leshabari, Melkizedeck; Metta, Emmy; Leyna, Germana; Mmbaga, Elia J.
    Background There is evidence that pre-exposure prophylaxis (PrEP) is effective in preventing HIV transmission, and PrEP is recommended by the World Health organization (WHO) for use by individuals at high risk of HIV infection. However, low adherence has been reported to hamper its effectiveness. Some evidence indicates that mHealth interventions may be a promising way of promoting PrEP adherence. Nevertheless, evaluations of mHealth interventions in Africa, the region most affected by HIV, are scarce. This study aimed at identifying the extent of and predictors for use of a smartphone based mHealth application among female sex workers in Dar es Salaam, Tanzania. Methods As part of a quasi-experimental study in Tanzania, 470 female sex workers who were eligible for PrEP and who owned a smartphone were recruited using respondent driven sampling. All participants were provided with an mHealth application called Jichunge, a smartphone-based app designed to promote adherence to PrEP by offering users information, advise and support during start-up and use of PrEP. We collected data through structured interviews at baseline and extracted user data from the app for a period of 30 days. Modified Poisson regression model with robust standard errors was used to identify predictors for the optimal use of the Jichunge app. Results Overall, the optimal use of the Jichunge app was 46.4%. Optimal use was significantly higher among women who were older (aPR = 1.3, 95% CI: 1.10-1.65, p = 0.004 for age 25-34 years, and aPR = 1.6, 95% CI: 1.19-2.07, p = 0.001 for age at least 35 years), who had secondary education or higher (aPR = 1.8, 95% CI: 1.08-2.94, p = 0.023), who had suboptimal social support (aPR = 1.2, 95% CI: 1.02-1.48, p = 0.030), who had high awareness of PrEP (aPR = 1.3, 95% CI: 1.08-1.55, p = 0.005), and who had experience using common mainstream social media applications (aPR = 1.4, 95% CI: 1.08-1.71, p = 0.009). Conclusion Optimal use of the Jichunge app was substantially higher among women with higher age, higher education, higher PrEP awareness, less social support, and experience using common social media applications. Individual and interpersonal factors should be considered in planning mHealth interventions. Further studies to determine predictors of longer-term mHealth engagement are needed.
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    Predictors of mHealth use in promoting adherence to pre-exposure prophylaxis among female sex workers: an evaluation of the Jichunge intervention in Dar es Salaam, Tanzania
    (Springer Nature, 2022-07-04) Mbotwa, Christopher; Kazaura, Method; Leshabari, Melkizedeck; Metta, Emmy; Leyna, Germana; Mmbaga, Elia J
    Background There is evidence that pre-exposure prophylaxis (PrEP) is effective in preventing HIV transmission, and PrEP is recommended by the World Health organization (WHO) for use by individuals at high risk of HIV infection. However, low adherence has been reported to hamper its effectiveness. Some evidence indicates that mHealth interventions may be a promising way of promoting PrEP adherence. Nevertheless, evaluations of mHealth interventions in Africa, the region most affected by HIV, are scarce. This study aimed at identifying the extent of and predictors for use of a smartphone based mHealth application among female sex workers in Dar es Salaam, Tanzania. Methods As part of a quasi-experimental study in Tanzania, 470 female sex workers who were eligible for PrEP and who owned a smartphone were recruited using respondent driven sampling. All participants were provided with an mHealth application called Jichunge, a smartphone-based app designed to promote adherence to PrEP by offering users information, advise and support during start-up and use of PrEP. We collected data through structured interviews at baseline and extracted user data from the app for a period of 30 days. Modified Poisson regression model with robust standard errors was used to identify predictors for the optimal use of the Jichunge app. Results Overall, the optimal use of the Jichunge app was 46.4%. Optimal use was significantly higher among women who were older (aPR = 1.3, 95% CI: 1.10-1.65, p = 0.004 for age 25-34 years, and aPR = 1.6, 95% CI: 1.19-2.07, p = 0.001 for age at least 35 years), who had secondary education or higher (aPR = 1.8, 95% CI: 1.08-2.94, p = 0.023), who had suboptimal social support (aPR = 1.2, 95% CI: 1.02-1.48, p = 0.030), who had high awareness of PrEP (aPR = 1.3, 95% CI: 1.08-1.55, p = 0.005), and who had experience using common mainstream social media applications (aPR = 1.4, 95% CI: 1.08-1.71, p = 0.009). Conclusion Optimal use of the Jichunge app was substantially higher among women with higher age, higher education, higher PrEP awareness, less social support, and experience using common social media applications. Individual and interpersonal factors should be considered in planning mHealth interventions. Further studies to determine predictors of longer-term mHealth engagement are needed.
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    Predictors of mHealth use in promoting adherence to pre‑exposure prophylaxis among female sex workers: an evaluation of the Jichunge intervention in Dar es Salaam, Tanzania
    (Springer Nature, 2021-07-04) Mbotwa, Christopher; Method, Kazaura; Moen, Kåre; Leshabari, Melkizedeck; Metta, Emmy; Leyna, Germana; Mmbaga, Elia J.
    Background There is evidence that pre-exposure prophylaxis (PrEP) is effective in preventing HIV transmission, and PrEP is recommended by the World Health organization (WHO) for use by individuals at high risk of HIV infection. However, low adherence has been reported to hamper its effectiveness. Some evidence indicates that mHealth interventions may be a promising way of promoting PrEP adherence. Nevertheless, evaluations of mHealth interventions in Africa, the region most affected by HIV, are scarce. This study aimed at identifying the extent of and predictors for use of a smartphone based mHealth application among female sex workers in Dar es Salaam, Tanzania. Methods As part of a quasi-experimental study in Tanzania, 470 female sex workers who were eligible for PrEP and who owned a smartphone were recruited using respondent driven sampling. All participants were provided with an mHealth application called Jichunge, a smartphone-based app designed to promote adherence to PrEP by offering users information, advise and support during start-up and use of PrEP. We collected data through structured interviews at baseline and extracted user data from the app for a period of 30 days. Modified Poisson regression model with robust standard errors was used to identify predictors for the optimal use of the Jichunge app. Results Overall, the optimal use of the Jichunge app was 46.4%. Optimal use was significantly higher among women who were older (aPR = 1.3, 95% CI: 1.10-1.65, p = 0.004 for age 25-34 years, and aPR = 1.6, 95% CI: 1.19-2.07, p = 0.001 for age at least 35 years), who had secondary education or higher (aPR = 1.8, 95% CI: 1.08-2.94, p = 0.023), who had suboptimal social support (aPR = 1.2, 95% CI: 1.02-1.48, p = 0.030), who had high awareness of PrEP (aPR = 1.3, 95% CI: 1.08-1.55, p = 0.005), and who had experience using common mainstream social media applications (aPR = 1.4, 95% CI: 1.08-1.71, p = 0.009). Conclusion Optimal use of the Jichunge app was substantially higher among women with higher age, higher education, higher PrEP awareness, less social support, and experience using common social media applications. Individual and interpersonal factors should be considered in planning mHealth interventions. Further studies to determine predictors of longer-term mHealth engagement are needed.