Determinants of Digitalized Antenatal Education Use among Pregnant Women Living with Human Immunodeficiency Virus in Nigeria.

Abstract

Background and objective: The introduction of digital health has been found to improve maternal health globally. However, the use and determinants of digitalized antenatal education (DAE) use among vulnerable populations are yet to be ascertained. Therefore, this study assessed the use and determinants of DAE use among pregnant women living with human immunodeficiency viruses (PWLHIV).

Methods: The study adopted a descriptive design. Oyo state was randomly selected in Southwestern Nigeria, and 116 PWLHIV, who are receiving antiretroviral therapy, were recruited for the study. Of these, 93 returned completed data, which were included in the data analysis. A validated online questionnaire was used for data collection. Data analysis was done using STATA version 17. Descriptive statistics were used to assess the use, feasibility, and acceptability of DAE. Logistic regression was used to identify the determinants of DAE use.

Results: Most (78 [83.9%]) of the participants reported that they have never used DAE. Similarly, 72 (77.4%) reported that they were not familiar with DAE at all. However, 84 (90.3%) of the women believed that it would be highly effective. The feasibility of DAE use is high in 83 (89%) of the participants. Furthermore, the majority of the participants, 73 (78.5%), indicated that DAE addresses their specific needs, and 77 (82.8%) of them reported being very comfortable with using DAE. The level of acceptability of DAE use is high in 73 (78.5%) of the participants. Determinants of DAE use, using adjusted odds ratio (AOR), include internet access (AOR = 1.205 with 95% confidence intervals [CI] of 0.233-6.221 and p = 0.024) and digital literacy (AOR = 14.072 with 95% CI of 2.209-89.634, and p = 0.005).

Conclusion and global health implications: Despite the high feasibility and acceptability of DAE in Nigeria, its use is very low among PWLHIV. Strong determinants of use include digital literacy and internet access. Thus, for PWLHIV to meet the global standard in the use of digital health, interventions to improve digital literacy and internet access in low-resource settings are recommended.