{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T20:09:25Z","timestamp":1788898165116,"version":"build-2803163510"},"reference-count":37,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Smartphones provide a precise method to study human mobility at an unprecedented scale, allowing researchers to explore the links between mobility, HIV risk, and treatment outcomes. However, leveraging smartphone technology to study HIV risk in rural settings presents unique challenges and opportunities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study assessed the feasibility of using smartphone GPS technology to collect mobility data from young adults in rural KwaZulu Natal, South Africa. We also present key lessons learned during the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study was conducted in 2 phases (June 2021-May 2023) with males and females aged 20\u201030 years old. In phase I, participants received smartphones with a customized study app (Avicenna research software). In phase II, they used their personal smartphones and installed the study app. The app used Android location services to record the smartphone location every 30 minutes and send it to a secure study server hourly. Participants were followed up for 6 months (26 wk). If location data were missing for 48\u201072 hours, participants were contacted for troubleshooting. Engagement strategies, including reverse billing and gamification (Wheel of Fortune), were implemented to address internet connection barriers and aid data collection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 207 participants were enrolled (phase I: 163; phase II: 44) with 204 providing mobility data. Participants recorded 27.6 million location points with a median number of 74,865 (IQR 28,471\u2010186,578) per participant. The mean weekly location points recorded was 95.3 out of 336 possible half-hour intervals (28.4%). Phase II saw more stable data collection in the latter half of the study, due to increased user engagement with the app. Challenges included phone-related issues (screen malfunctions, lost and broken phone), app terminations, and limited internet connectivity. Reverse billing and gamification strategies improved location data collection through increased user engagement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrates that the use of smartphone-based GPS technology is feasible among young adults in a rural South African setting. Although only 28.4% (95.3\/336) of expected weekly location data were collected, the study offers insights into engagement strategies that can be used to enhance location data collection in similar contexts. Continuous troubleshooting identified challenges and informed solutions to data collection gaps. Reverse billing system and gamification resulted in significant increases in location data received. These findings underscore the potential of integrating mobile health tools into health systems to better support high-risk mobile populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/67519","type":"journal-article","created":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T16:55:06Z","timestamp":1749228906000},"page":"e67519-e67519","source":"Crossref","is-referenced-by-count":1,"title":["Leveraging Smartphone Mobility Data to Understand HIV Risk Among Rural South African Young Adults: Feasibility Study"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2436-9972","authenticated-orcid":false,"given":"Thulile","family":"Mathenjwa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4159-9588","authenticated-orcid":false,"given":"Elphas Luchemo","family":"Okango","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1129-7674","authenticated-orcid":false,"given":"Khai Hoan","family":"Tram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9340-2054","authenticated-orcid":false,"given":"Maxime","family":"Inghels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7060-4203","authenticated-orcid":false,"given":"Diego","family":"Cuadros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5124-1555","authenticated-orcid":false,"given":"Hae-Young","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2282-1005","authenticated-orcid":false,"given":"Fiona","family":"Walsh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4182-4212","authenticated-orcid":false,"given":"Till","family":"Barnighausen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7793-2197","authenticated-orcid":false,"given":"Adrian","family":"Dobra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9797-0000","authenticated-orcid":false,"given":"Frank","family":"Tanser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"issue":"11","key":"R1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001905","article-title":"Mass HIV treatment and sex disparities in life expectancy: demographic surveillance in rural South Africa","volume":"12","author":"Bor","journal-title":"PLoS Med"},{"issue":"6","key":"R2","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1056\/NEJMoa1105243","article-title":"Prevention of HIV-1 infection with early antiretroviral therapy","volume":"365","author":"Cohen","journal-title":"N Engl J Med"},{"issue":"6122","key":"R3","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1126\/science.1228160","article-title":"High coverage of ART associated with decline in risk of HIV acquisition in rural KwaZulu-Natal, South Africa","volume":"339","author":"Tanser","journal-title":"Science"},{"key":"R4","unstructured":"UNAIDS 2022 Epidemiological Estimates. UNAIDS; 2022."},{"issue":"Suppl 4","key":"R5","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25136","article-title":"Bringing population mobility into focus to achieve HIV prevention goals","volume":"21","author":"Camlin","journal-title":"J Int AIDS Soc"},{"issue":"2","key":"R6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0000105","article-title":"The role of high-risk geographies in the perpetuation of the HIV epidemic in rural South Africa: A spatial molecular epidemiology study","volume":"2","author":"Cuadros","journal-title":"PLOS Glob Public Health"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1097\/QAD.0000000000001292","article-title":"Space-time migration patterns and risk of HIV acquisition in rural South Africa","volume":"31","author":"Dobra","journal-title":"AIDS"},{"issue":"1","key":"R8","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1186\/s12889-019-6494-x","article-title":"Effect of ART scale-up and female migration intensity on risk of HIV acquisition: results from a population-based cohort in KwaZulu-Natal, South Africa","volume":"19","author":"Dzomba","journal-title":"BMC Public Health"},{"issue":"2","key":"R9","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1097\/QAI.0000000000001349","article-title":"Social disequilibrium and the risk of HIV acquisition: a multilevel study in rural KwaZulu-Natal Province, South Africa","volume":"75","author":"Tomita","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"3","key":"R10","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26058","article-title":"Mobility and HIV care engagement: a research agenda","volume":"26","author":"Thorp","journal-title":"J Int AIDS Soc"},{"issue":"3","key":"R11","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1097\/QAD.0000000000002100","article-title":"Sociobehavioral and community predictors of unsuppressed HIV viral load: multilevel results from a hyperendemic rural South African population","volume":"33","author":"Tomita","journal-title":"AIDS"},{"issue":"1","key":"R12","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1097\/QCO.0000000000000415","article-title":"HIV outcomes among migrants from low-income and middle-income countries living in high-income countries: a review of recent evidence","volume":"31","author":"Ross","journal-title":"Curr Opin Infect Dis"},{"issue":"6","key":"R13","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1097\/COH.0000000000000192","article-title":"HIV treatment cascade in migrants and mobile populations","volume":"10","author":"Tanser","journal-title":"Curr Opin HIV AIDS"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2023.2229895","article-title":"Making sense of uncertainty: The precarious lives of young migrants from rural Kwazulu-Natal, South Africa","volume":"18","author":"Ngwenya","journal-title":"Glob Public Health"},{"issue":"1","key":"R15","doi-asserted-by":"publisher","first-page":"944","DOI":"10.1186\/s12889-020-09085-7","article-title":"Understanding mobility and sexual risk behaviour among women in fishing communities of Lake Victoria in East Africa: a qualitative study","volume":"20","author":"Kwena","journal-title":"BMC Public Health"},{"issue":"12","key":"R16","doi-asserted-by":"publisher","first-page":"e787","DOI":"10.1016\/S2352-3018(21)00267-8","article-title":"The potential impact of country-level migration networks on HIV epidemics in sub-Saharan Africa: the case of Botswana","volume":"8","author":"Okano","journal-title":"Lancet HIV"},{"issue":"6","key":"R17","doi-asserted-by":"publisher","first-page":"1396","DOI":"10.1007\/s10461-018-2367-z","article-title":"Effects of migration on risky sexual behavior and HIV acquisition in South Africa: a systematic review and meta-analysis, 2000-2017","volume":"23","author":"Dzomba","journal-title":"AIDS Behav"},{"issue":"Suppl 4","key":"R18","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25128","article-title":"The impact of population dynamics on the population HIV care cascade: results from the ANRS 12249 Treatment as Prevention trial in rural KwaZulu-Natal (South Africa)","volume":"21","author":"Larmarange","journal-title":"J Int AIDS Soc"},{"issue":"2","key":"R19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0147520","article-title":"Feasibility and acceptability of global positioning system (GPS) methods to study the spatial contexts of substance use and sexual risk behaviors among young men who have sex with men in New York City: a P18 cohort sub-study","volume":"11","author":"Duncan","journal-title":"PLoS One"},{"issue":"9","key":"R20","doi-asserted-by":"publisher","first-page":"3057","DOI":"10.1007\/s10461-018-2163-9","article-title":"Collecting mobility data with GPS methods to understand the hiv environmental riskscape among young Black men who have sex with men: a multi-city feasibility study in the Deep South","volume":"22","author":"Duncan","journal-title":"AIDS Behav"},{"issue":"4","key":"R21","doi-asserted-by":"publisher","first-page":"723","DOI":"10.4269\/ajtmh.2010.09-0496","article-title":"Assessing and maximizing the acceptability of global positioning system device use for studying the role of human movement in dengue virus transmission in Iquitos, Peru","volume":"82","author":"Paz-Soldan","journal-title":"Am J Trop Med Hyg"},{"issue":"3","key":"R22","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1080\/19320248.2015.1112754","article-title":"Participant experience using GPS devices in a food environment and nutrition study","volume":"11","author":"Williams","journal-title":"J Hunger Environ Nutr"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2018.01.003","article-title":"User acceptance of location-tracking technologies in health research: Implications for study design and data quality","volume":"79","author":"Hardy","journal-title":"J Biomed Inform"},{"issue":"4","key":"R24","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1111\/dewb.12376","article-title":"Ethical considerations in using a smartphone-based GPS app to understand linkages between mobility patterns and health outcomes: The example of HIV risk among mobile youth in rural South Africa","volume":"23","author":"Mathenjwa","journal-title":"Dev World Bioeth"},{"issue":"4","key":"R25","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1080\/17450128.2020.1739359","article-title":"Being young and on the move in South Africa: how \u2018waithood\u2019 exacerbates HIV risks and disrupts the success of current HIV prevention interventions","volume":"15","author":"Bernays","journal-title":"Vulnerable Child Youth Stud"},{"issue":"6","key":"R26","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1097\/COH.0000000000000203","article-title":"Innovations in health and demographic surveillance systems to establish the causal impacts of HIV policies","volume":"10","author":"Herbst","journal-title":"Curr Opin HIV AIDS"},{"issue":"10","key":"R27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0203193","article-title":"Persistently high incidence of HIV and poor service uptake in adolescent girls and young women in rural KwaZulu-Natal, South Africa prior to DREAMS","volume":"13","author":"Chimbindi","journal-title":"PLoS One"},{"issue":"28","key":"R28","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2013164118","article-title":"Large age shifts in HIV-1 incidence patterns in KwaZulu-Natal, South Africa","volume":"118","author":"Akullian","journal-title":"Proc Natl Acad Sci USA"},{"key":"R29","unstructured":"Avicenna. 2024. URL: https:\/\/avicennaresearch.com\/ [Accessed 13-08-2025]"},{"key":"R30","unstructured":"Datafree Technologies; 2024. URL: https:\/\/datafree.tech\/ [Accessed 13-08-2025]"},{"issue":"1","key":"R31","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1089\/trgh.2017.0003","article-title":"Acceptability and feasibility of using a novel geospatial method to measure neighborhood contexts and mobility among transgender women in New York City","volume":"2","author":"Goedel","journal-title":"Transgend Health"},{"issue":"1","key":"R32","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0210240","article-title":"Acceptability of smartphone applications for global positioning system (GPS) and ecological momentary assessment (EMA) research among sexual minority men","volume":"14","author":"Duncan","journal-title":"PLoS One"},{"issue":"1","key":"R33","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0290634","article-title":"Finding women in fishing communities around Lake Victoria: \u201cFeasibility and acceptability of using phones and tracking devices\u201d","volume":"19","author":"Nanyonjo","journal-title":"PLoS One"},{"key":"R34","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2018.03.005","article-title":"Considering high alcohol and violence neighborhood context using daily diaries and GPS: A pilot study among people living with HIV","volume":"187","author":"Theall","journal-title":"Drug Alcohol Depend"},{"issue":"7","key":"R35","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.8376","article-title":"Improving linkage to HIV care through mobile phone apps: randomized controlled trial","volume":"6","author":"Venter","journal-title":"JMIR Mhealth Uhealth"},{"issue":"1","key":"R36","doi-asserted-by":"publisher","DOI":"10.2196\/44945","article-title":"The implementation of a GPS-based location-tracking smartphone app in South Africa to improve engagement in HIV care: randomized controlled trial","volume":"11","author":"Clouse","journal-title":"JMIR Mhealth Uhealth"},{"issue":"8","key":"R37","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1080\/10447318.2016.1183330","article-title":"Gamification Solutions to Enhance Software User Engagement\u2014A Systematic Review","volume":"32","author":"Darejeh","journal-title":"Int J Hum Comput Interact"}],"container-title":["JMIR mHealth and uHealth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/mhealth.jmir.org\/2025\/1\/e67519","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:27:52Z","timestamp":1785536872000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhealth.jmir.org\/2025\/1\/e67519"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,25]]},"references-count":37,"URL":"https:\/\/doi.org\/10.2196\/67519","relation":{},"ISSN":["2291-5222"],"issn-type":[{"value":"2291-5222","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,25]]},"article-number":"v13i11e67519"}}