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MASI logoDeveloping a Smartphone App to Improve Treatment Adherence among South African Adolescents Living with HIV


Study Implementers: University of Cape Town (South Africa), Duke University School of Nursing (USA), and University of North Carolina (USA)
Study Sponsor: U.S. National Institute of Mental Health
Grant #: 1K01MH118072-01A1
Principal Investigator: Dr. Marta Mulawa (Duke University)
Co-Investigators: Dr. Jackie Hoare (University of Cape Town) and Dr. Lisa Hightow-Weidman (University of North Carolina)


Screenshot of MASI home screen with an avatar of a black woman, today's tasks - just for you which includes activities, articles, and posts. Text above it that says MASI is an app for South African youth to connect and find resources for a healthy, empowered life.

The purpose of this study is to customize and pilot MASI (MAsakhane Siphucule Impilo Yethu, Xhosa for “Let’s empower each other and improve our health”), an app-based intervention to promote adherence to HIV treatment among adolescents living with perinatally-acquired HIV in Cape Town, South Africa.

MASI is built using the HealthMpowerment platform. Through an anonymous interactive discussion forum, MASI provides opportunities for participants to interact with each other and trained peer mentors to receive and provide social support. Through the health tracker, MASI provides opportunities for participants to self-monitor their treatment adherence and schedule tailored reminders. MASI also supports goal-setting and action planning by guiding participants through activities where they can identify goals, select action items, and receive tailored feedback on the action plan. Finally, through numerous activities (including quizzes, self-assessments, and goal-setting activities), multi-media resources, and an Ask the Expert area of the app, MASI provides opportunities for participants to review comprehensive health information in engaging formats

We are in the process of iteratively customizing MASI through in-depth interviews and app-testing with adolescents living with HIV in Cape Town. We recently conducted in-depth interviews with 15 adolescents to inform the development and customization of content to address their needs. Next, we will conduct app testing of MASI. Study activities for this phase of research will include a set of two in-depth interviews with 12-16 adolescents living with HIV. During the first interview, we will install MASI on each participant’s phone. Participants will be asked to spend at least 10 minutes a day on the app for 1-3 weeks, until the second interview is scheduled. A second interview will allow participants to provide feedback based on their experience with the app, desired improvements, proposed changes to the community guidelines, and information on facilitators and barriers to uptake and daily engagement as well as any technical difficulties encountered, privacy or confidentiality concerns.

This study is approved the University of Cape Town Human Research Ethics Committee (HREC Ref: 606/2020) and the Duke University Health System Institutional Review Board (Protocol ID: Pro00103309).


Research Team

Screenshot of MASI home screen with text above it that says A research study by the University of Cape Town, Duke University, and the University of North CarolinaDuke University PI:
Marta Mulawa, PhD, MHS
Duke University School of Nursing

University of Cape Town Site PI:
Jacqueline Hoare, MBChB, PhD
University of Cape Town
Department of Psychiatry and Mental Health

University of Cape Town Research Manager:
Bulelwa Mtukushe
University of Cape Town
Department of Psychiatry and Mental Health

University of North Carolina Co-I:
Lisa Hightow-Weidman, MD, MPH
Professor, Division of Infectious Diseases