“Un Amigo Secreto”: Perceived acceptability of a chatbot for depression education, self-help and linkage to care among adolescents living with HIV in Peru

Abstract

Adolescents living with HIV (ALWH) in Peru face significant mental health challenges, including a high prevalence of low-to-moderate depression, exacerbated by limited access to mental health resources. This study explores the perceived acceptability of a chatbot to support depression education, self-help, and linkage to care among ALWH. Focus groups and interviews were conducted with 28 adolescents, 5 caregivers, and 5 HIV care personnel. A semi-structured interview guide with open-ended questions was used to assess seven core chatbot acceptability domains: affective attitude, ethics, burden, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy. Across a diverse sample based on sex, gender, sexuality and age, most participants expressed positive attitudes towards a mental health chatbot, highlighting its potential to provide a non-threatening and accessible source of information and support. Participants appreciated a chatbot’s potential to offer immediate responses and facilitate a safe space for ALWH to communicate their needs in moments of isolation. Participants understood the three main purposes of the chatbot and had confidence in their abilities to successfully use a mental health chatbot. However, concerns were raised regarding a chatbot's inability to provide human empathy and potential privacy issues related to data security. Despite some reservations, participants generally believed that a chatbot could effectively deliver educational content, promote self-help strategies, and serve as a bridge to professional care. These findings highlight the perceived acceptability of a chatbot as a mental health intervention for Peruvian ALWH.