A Qualitative Study of Mobile Technology Use and Perceived Barriers to mHealth Interventions for Youth Living with HIV in the Southern United States

Youth living with HIV (YLHIV) in the southern United States (US) experience poor outcomes across the HIV care continuum. Mobile health (mHealth) tools offer promise in overcoming barriers to care for youth. This qualitative study aimed to understand use of mobile technology among YLHIV in South Carolina and to identify barriers to mHealth interventions. HIV care providers (n=15), community-based organization (CBO) staff (n=23), and YLHIV (n=16) completed individual, semi-structured interviews (i.e., providers and youth) or focus groups (i.e., CBO staff). Rapid qualitative analysis was used to identify salient themes. Data analysis indicated that YLHIV are deeply immersed in digital worlds, yet routinely keep their HIV status concealed online, citing barriers related to privacy and confidentiality. Other barriers included the lack of integration of mHealth tools with electronic medical record systems. Structural barriers included the rural-urban ‘digital divide’ and widespread poverty. Implications for development of feasible mHealth tools are discussed.