Using interactive SMS support groups to prevent mother-to-child HIV transmission in South Africa: a qualitative analysis of social and psychological benefits

Although advances have been made in the prevention of mother-to-child transmission (PMTCT) of HIV, social and psychological factors associated with learning of an HIV diagnosis and living with HIV during pregnancy can impact medication adherence and health outcomes. Mobile technology can increase social support; however, it is unclear if such technology can be used to provide social support to reduce negative psychological outcomes. This study analysed the feasibility of conducting a multi-way interactive SMS-based support group with HIV-positive women in the PMTCT programme in clinics of Tshwane, South Africa. We studied the types of social support women received through using this mobile technology to address personal, interpersonal and social barriers to PMTCT adherence. We analysed the social and psychological content of SMS messages sent between seven HIV-positive pregnant women participating in a 12-week interactive support group. We conducted a qualitative, thematic analysis of the 734 text messages. Five social/psychological themes emerged: appraisal and emotional support, informational support, spiritual support, acceptance and disclosure of HIV status, and gratefulness for the support group, suggesting benefits of the interactive SMS-based support group. This interactive support model can provide social support and information to pregnant women living with HIV, leading to a reduction in isolation and negative psychological outcomes which could promote positive health outcomes.