Mobile technologies, social media ignite HIV prevention revolution in Africa

Activists and social media experts met in Cape Town, where the HIV morbidity and mortality rates are among the highest in the world.

A joint meeting between the United Nations Program on HIV/AIDS and Stellenbosch University last month raised awareness of HIV prevention among adolescents in Africa by “engaging adolescents in defining the prevention interventions that work for them,” according to Michel Sidibé, executive director of UNAIDS.

Of 3,000 young people infected with HIV daily, only one in three have full knowledge of how HIV is transmitted, according to a UNAIDS report. For this reason, AIDS activists, technology leaders and social media experts met in Cape Town, South Africa, where the HIV morbidity and mortality rates are among the highest in the world.

“We must engage young people in defining the prevention interventions that work for them,” said Sidibé. “The potential of social media and mobile technologies to re-energize the AIDS movement is clear. We need nothing less than an HIV prevention revolution, with social media and mobile technology at its core.”

Throughout the world, social media and mobile technologies have the potential to prevent HIV by spreading awareness. These technologies can provide online resources, information, and learning opportunities for anonymous gathering of health information, including HIV/AIDS, and stress reduction/coping methods for post-diagnosis treatment.

During the meeting, particular emphasis was placed on mobile technologies in Africa, where there are currently 333 million mobile cell phone users when compared with 77 million computer users, Sidibé said. “Mobile phones are the answer in South Africa; more people here use cell phones than the Internet,” Jan du Toit, director of the Africa Centre for HIV/AIDS Management, and professor at Stellenbosch University said during the meeting.

With a significant burden of disease, weak health infrastructure and a staggering number of mobile phones, use of this technology has the potential to strengthen the health sector in South Africa.

The use of mobile technology for preventive health measures will allow infectious disease physicians to communicate pertinent information directly to an accessible and captive audience. Additionally, the speakers theorized that peer-to-peer information sharing via mobile cell phone has the potential to decrease the spread of HIV/AIDS in Africa while increasing access to information.

The power of mobile technology

Presenters discussed new forms of mobile technologies and the power of these innovations to spread through social media. The discussion was based around the question of how to embrace this revolution of social media and mobile technologies to bring about social change.

One such platform, Young Africa Live, is a mobile social community developed for youth to post comments and generate discussions around sexual health and HIV/AIDS. “Considering the context of Young Africa Live, the topic of HIV/AIDS is one that is often discussed because of the impact this has on the lives of the users of the portal,” said Debbie Rogers, of the Praekelt Foundation. The platform has reached 32 million page views and generated more than 950,000 comments within the past year, she added.

Peter Benjamin, managing director of Cell Life, a non-profit organization in Cape Town, presented a mobile phone platform, Cellphones for HIV, that allows for cell phone services to provide information and communication services that are useful to people infected or affected by HIV.

“Most people in South Africa don’t have access to Twitter and don’t have access to Facebook, but they do have access to cell phones,” Benjamin said. “In fact, 90% of all youth and adults in this country have a cell phone. We are using text messaging to send positive messages to people on ART, to increase adherence and reduce loss-to-follow-up.”

Other key initiatives of this project include mass messaging for prevention, mass information for positive living, linking patients and clinics, peer-to-peer support and counseling, and monitoring and evaluation.

An instant messaging application (MXit) that originated at Stellenbosch University has more subscribers than Facebook in Africa. Adolescents in this country have embraced this mobile social network with nearly 350 million messages per day and more than 27 million users, according to Marlon Parker, founder of Reconstructed Living Labs.

Supporting research

Besides utilizing mobile phone and social media technologies for HIV prevention methods, recent research supports the notion that those technologies can help to increase post-diagnosis treatment, adherence, and follow-up by allowing physicians to educate and stay in constant contact with patients.

As previously reported in Infectious Disease News, researchers for the WelTel1 Kenya trial used evolving mobile technology to promote behavioral change. During the trial, infectious disease physicians communicated with and followed up with HIV-infected patients via text messaging. Post-trial analysis revealed that significant improvements were observed in ART adherence and in the rates of viral load suppression.

“We learned that focusing on patient-centered support vs. health care system monitoring made the system popular among patients and may have contributed toward the apparent behavior change that we documented,” Richard T. Lester, MD told Infectious Disease News. “We now have the first evidence-based program that shows improved health outcomes in the developing world setting. A simple low-cost system that harnesses the expanding mobile phone market, even in resource limited settings, can improve medication adherence and the ultimate goal of suppressing HIV virus to undetectable levels.”

In a similar program, Sheana Bull, PhD, MPH, associate professor at the Colorado School of Public Health, and colleagues demonstrated the feasibility and acceptability of cell phones use to deliver HIV prevention content to young black men in the US — a group at highest risk for HIV in this country.

“HIV risk is exacerbated by lack of consistent condom use, having multiple partners and partners with high risk, and a history of STI,” Bull said. “If we can use cell phones in a simple intervention that links men accessing STI diagnosis and treatment to regular text reminders to test for STI and HIV as long as they continue to have any risk, it could increase repeat testing, an important outcome needed to get more people diagnosed and into care.”

Movement toward a ‘revolution’

At the end of the meeting, Olga Rudneva, executive director of the Elena Pinchuk ANTIAIDS Foundation announced a competition for developing mobile applications for HIV prevention, challenging the world to come up with a social network project to prevent HIV.

“We realized that the best way to build successful intervention or a great media campaign — is to ask the target audience. They know better what works for them and how messages should be communicated to them. The most creative projects with well-defined budgets and targets will be awarded with full or partial funding.”

Rudneva said the projects should:

• Raise awareness about HIV/AIDS, ways of using transmission social media platforms or mobile applications.
• Establish communication platform using social media to discuss safe sex, HIV/AIDS, stigma and discrimination issues.
• Create innovative ways of communication using social media.
• Create easy-to-use mobile applications to spread information and news about HIV/AIDS, safe sex and HIV/AIDS resources.
• Establish blogging and photo blogging platform to exchange ideas about fight against HIV/AIDS.

“The effective use of social media and mobile technology for HIV prevention will bring hope to a generation whose future continues to be threatened by AIDS,” said Russel Botman, professor, and vice-chancellor of Stellenbosch University. – by Ashley DeNyse

For more information:

• Juzang I. J Telemed Telecare. 2011;17:150-153.
• Lester RT. Lancet. 2010;doi:10.1016/S0140-6736(10)61997-6.
• UNAIDS. Report on the global AIDS epidemic 2010: www.unaids.org/globalreport/Global_report.htm
• Wei J. J Telemed Telecare. 2011; 17:41–48.

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