Health promotion messaging reduces HIV risk behaviours and improves repeat testing among adolescent girls and young women in Kenya.

Abstract

Adolescents and young people in sub-Saharan Africa account for about a third of persons newly diagnosed with HIV. Health communication, through mobile health (mHealth) can improve access to sexual and reproductive health information, health services and reduce risky sexual behaviours among adolescents and young people. We assessed the impact of a health promotion messaging intervention on the reduction of risky sexual behaviours among HIV-negative high risk adolescent girls and young women (AGYW). Newly diagnosed and sexually active AGYW of 15-24 years old were enrolled between May 2017 and April 2018 in the HIV positive and negative cohorts of the study. We utilised SMS (short message service) and unstructured supplementary service data (USSD) technology to deliver health promotion messages quarterly to the HIV-positive cohort and six-monthly to the HIV-negative cohort over 12 months. Both cohorts completed a SMS survey at the end of their scheduled study follow-up period. We enrolled 184 AGYW in the HIV-negative cohort with a mean age of 20.8 years, 28.6% began sexual activity before 15 years old, and 8.5% tested HIV-positive. Over 12 months, reported multiple sexual partnership reduced from 33% to 12% (p < 0.001) among AGYW who had multiple partners. HIV re-testing increased from 74.2% to 81.6% (p = 0.099). Those who knew their partner's HIV status increased from 70.9% to 85.7% (p <0.001). Our findings demonstrate that mobile phone text messaging is an effective and feasible method for sexual health promotion among young people. Specifically, SMS, which is simple, cost-effective and widely accepted, could be adopted by health intervention programmes as a strategy to effectively promote safer sex behaviours and retesting among high-risk HIV-negative AGYW.