Acceptability of SMS reminders as an HIV PREP adherence support tool and associated factors among adolescent girls and young women in Mukono District

Abstract

Background: Young Women in Uganda contributed 29% of new HIV infections despite representing only 10% of the total population and are priority beneficiaries of PrEP, yet they have been found to have low adherence. SMS reminders have been found to improve adherence to PrEP in AGYW. There is paucity of literature about their acceptability among AGYW in Mukono district. Objective: To estimate the level of acceptability, the associated factors and explore the perceptions toward use of SMS reminders as a PrEP adherence support tool and among AGYW in Mukono district. Methods: This parallel convergent mixed-methods study enrolled 142 AGYW using PrEP. A structured questionnaire and In-depth interview guide were used to collect quantitative and qualitative data respectively. Quantitative data were analyzed in STATA 17.0 Continuous variables were summarized using median (IQR) and factors associated with acceptability of SMS reminders were analyzed using a modified Poisson regression. Qualitative data were analyzed by inductive thematic analysis in open code version 4.03. Results: The acceptability of SMS reminders was 90.9% (95% CI (84.9, 95.0)). Being from rural residence and not believing that SMS can breach individual’s privacy were significantly associated with acceptability of SMS reminders with adjusted prevalence ratios of 0.92 (95% CI (0.84, 0.99)) and 1.4 (95% CI (1.07, 1.84)) respectively. AGYW perceived that SMS reminders are highly acceptable to support adherence. However, they felt that the success of this intervention hinges on whether it ensures confidentiality about their PrEP use. Conclusions: SMS reminders are highly acceptable to AGYW provided they ensure confidentiality is maintained however, AGYW living in rural areas may need additional support to use this intervention.