Abstract
This is a first of its kind study using smartphone-based GPS technology to record ultra-high resolution mobility patterns of approximately 800 young adults (comprising the Sesikona! Cohort) aged 20-30 years in rural KwaZulu Natal.
The Sesikhona! study aims to:
i) Determine typologies of movement in the age-group 20-30 in a HIV hyper-endemic population.
ii) Quantify movements in and out of known high HIV risk locations.
The long-term aim of the study is to design a location-intelligent smartphone intervention using real-time, precision messaging targeting those at high risk of HIV acquisition, transmission, and treatment failure.
This study involves young adults aged 20-30 years who participated in the 2019 AHRI HIV survey and are resident members in Sothern PIP area. The study collects longitudinal mobility data using a customized version of the Avicenna research platform, which uses Android location services to record the device's location at 30-minute intervals (initially every 5 minutes). Data are uploaded to a secure study server every hour. If location data were missing for 48-72 hours, participants were contacted by phone or visited at home) for troubleshooting. The study was conducted in 3 phases:
Phase I (Jun 2021 - Aug 2022): participants who consented to join the study were provided a smartphone or could opt to use their own device (smartphone), provided it met the technical requirements of the study protocol. In October 2021, an AHRI Connector app was introduced, enabling data upload via a secure VPN without requiring an data bundle on the device. Participants were followed for 6 months and completed monthly surveys assessing their experience, attitudes towards the study and protocol adherence.
Phase II (Jul 2022 - May 2023): all participants used their personal smartphones. To enhance study engagement, a gamified feature 'Wheel of Fortune' was introduced in October 2022, allowing participants to play daily for a chance to win prizes (data bundles, airtime and shopping vouchers). As in phase I, participants were followed for 6 months and completed the monthly surveys.
Phase III (Nov 2023 - Jun 2025): participants from phases I and II were reconsented and followed for an additional 12-18 months. P During this phase, they completed a series of surveys covering sexual behaviour, mental health, mobility and travel, mHealth readiness, and adherence to the study protocol.
Demographic data and consent were collected using REDCap. All mobility data and survey responses were collected via the Avicenna Research Platform app.
