Does time matter? cross–sectional evaluation of mhealth program enrollment duration on healthy behaviors among key populations in Lomé

Abstract

Context: Key populations (KP) in Togo, including men who have sex with men and female sex workers, experience disproportionately high rates of HIV prevalence. In response to this situation, USAID/West Africa and FHI360 established the PACTE–VIH regional HIV/AIDS project, which utilized mobile health (mHealth) to send reminders to enrolled participants on ways to reduce the risk of HIV infection. While mHealth programs are known to be effective in improving HIV–related health behavior outcomes, the role of length of time enrolled in a mHealth program is not well understood. Methods: To assess whether there was a relationship between time enrolled in the PACTE–VIH mHealth program and adoption of HIV prevention behavior, we use data from an operations research study conducted in Lomé, Togo, in 2016 with 1005 KP and employ logistic regression analysis. Results: The odds of adopting prevention behaviors were higher with each additional month enrolled in the program (OR: 1.62; 95% CI 1.19–2.20). Fully adjusted (age and marital status) logistic regression models demonstrated no significant difference in odds of adopting prevention behavior between enrollment times of less than six months and any category greater than six months. Conclusion: Time does matter for adoption of HIV prevention behaviors. However, more studies are needed to better understand what length of time enrolled in a program truly affects behavioral outcomes.