Pilot testing of a digitally enabled, peer supported self-management intervention for adolescents and youth living with HIV in the Western Cape, South Africa

Abstract

Adolescents and youth living with HIV (AYLHIV) face increased health risks and need targeted support to optimally engage in treatment. The Supporting Adolescents to be Resilient and Thrive (S-SMART) programme is a digitally enabled, peer-supported self-management intervention designed to enhance psychosocial and treatment engagement outcomes among AYLHIV. This pilot study evaluated the feasibility and acceptability of S-SMART among AYLHIV aged 15–21 years who received HIV treatment at two public primary care clinics in the Cape Town Metropole, South Africa. Thirteen AYLHIV received smartphones, mobile data, and access to the S-SMART app from September to December 2024. The pilot programme for S-SMART included activities, peer group sessions, and coaching by four peers living with HIV. Focus groups were conducted before (n = 17) and after (n = 12), to assess usability and their user experiences. Activity and programme completion was > 95%. Participants found the app user-friendly overall, though some faced issues with navigation, language and understanding certain content. Engagement was strengthened through peer support and facilitation. While the programme promoted psychosocial empowerment, HIV-related challenges such as stigma and disclosure fears need ongoing support.