"That courage to encourage": Participation and Aspirations in Chat-based Peer Support for Youth Living with HIV

We present a qualitative study of a six-month pilot of WhatsApp-based facilitated peer support groups, serving youth living with human immunodeficiency virus (HIV) in an informal settlement in Nairobi, Kenya. Popular chat apps are increasingly being leveraged to make a combination of patient-provider communication and peer support more accessible beyond formal healthcare settings. However, how these interventions are experienced in Global South contexts with phone sharing and intermittent data access is understudied. The context of stigmatized illnesses like HIV further complicates privacy concerns. We draw on chat records and interviews with youth and the facilitator to describe their experience of the intervention. We find that despite tensions in group dynamics, intermittent participation, and contingencies around privacy, youth were motivated by newfound aspirations and community to manage their health. We use our findings to discuss implications for the design of chat-based peer interventions, negotiation of privacy in mobile health applications, and the role of aspirations in health interventions.