Content-Analysis of Social Networks and Mobile Phone Text Messages Among HIV Patients in Tanzania

Jong, Soson

Purpose:

The study aimed to explore and understand HIV patients’ social networks and support in relation to their use of mobile text messages (SMS). This study also presents HIV patients’ perspectives on use of SMS for HIV care and management.

Mobile technology has become a promising communication and educational platform for both health care providers and patients. Mobile phone messages have been used to provide reminders to patients about medication adherence, medical appointments, and to encourage physical activities. The mobile technology appears to have more potential to improve health service delivery where health care infrastructure and human resources are limited.

Methods:

A qualitative content analysis was done on a survey of ‘social networks and mobile phone text message use’, part of a cross-sectional research study conducted among 163 HIV-positive patients attending outpatient HIV clinics in Dar es Salaam, Tanzania in 2015. Five multiple-choice questions and four open-ended questions and answers were included. Trained research assistants administered interviews in Swahili; responses were translated and transcribed into English. The open-ended answers were coded and analyzed. Conventional content analysis methods guided analysis of one hundred interviews.

Results:

The majority of participants were women (78%). The average age was 41.9 years (range, 22-77). PLWH’s closest social networks were identified as immediate family members, followed by extended friends and relatives. Neighbor and community members from religious organizations, NGOs, doctors and nurses were listed as part of their social networks. Phone calls (62%) and in-person communications (49%) were the most frequently used modes of conversation within the networks. Approximately 20% of the participants reported no use of SMS due to 'vision problems', 'prefer calling', or 'not accustomed to SMS'. Seventy-three percent of participants sent none to 10 SMS over one week. Affordability, accessibility, and privacy are the top three stated reasons for preferring SMS. If SMS were cost-free, PLWH would prefer to receive text messages about health, life skills, greetings, religious messages, informational and educational contents. Specific to HIV/AIDS care, participants would like to receive SMS reminding them of clinic appointments before antiretroviral medication runs out. Participants also requested HIV health information focusing on nutrition and medication. The sense of “being supported and cared for” was the most frequently cited reason for acceptability of SMS use in relation to HIV. Four participants mentioned concerns about privacy.

Conclusion:

SMS is an affordable and well-accepted mode of communication among this sample of Tanzanians living with HIV. SMS can be used to improve PLWH’s knowledge about the management of their chronic health status, retention and engagement to care. Provision of informational and educational content should be tailored for individual needs for chronic disease management.