Published in PLOS One on 2026-05-29, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Olaposi Joseph Olatoregun, Lisa Hightow-Weidman, Marta Mulawa, Lauren Jennings, Jay Osi Samuels, Prosper Okonkwo, Catherine Orrell
Source: PLOS One • DOI 10.1371/journal.pone.0350279
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Adolescents and young adults living with HIV (AYALHIV) face persistent challenges with antiretroviral therapy (ART) adherence, a key determinant of viral suppression and long-term health outcomes. The Lu Dedoo Project sought to adapt the existing (Masakhane Siphucule Impilo Yethu (MASI) adherence app, originally developed for South Africa, for AYALHIV in Benue State, Nigeria. Guided by a human-centered design (HCD) framework, the project engaged end users to ensure that the app was contextually relevant, user-friendly, and responsive to local needs prior to pilot testing.
Beta testing was conducted where purposively selected AYALHIV used MASI in its existing form for one month. Three subsequent FGDs were held among beta testers, involving a total of 22 participants: one mixed-gender adolescent group aged 15–19 years (n = 6), one male young adult group aged 20–24 years (n = 8), and one female young adult group aged 20–24 years (n = 8). FGDs were analysed using thematic analysis in NVivo® v15. Transcripts were analysed thematically to identify user experiences and desired modifications. Identified features were then prioritised using the MoSCoW method (“Must have,” “Should have,” “Could have,” “Won’t have”) to guide development decisions and ensure feasible, user-driven adaptation.
Participants found the app highly engaging and liked the games, quizzes, and the ability to earn badges. These features contributed to user retention and supported their medication adherence. A subset of participants noted the challenge of needing cellular data access to use the app. “Must have” priorities included offline access to key features, simplified navigation, and customizable medication reminders. “Should have” and “Could have” priorities included adding more engaging media content and enhancing personalised reminders to better meet user needs.
Applying an HCD framework, complemented by MoSCoW prioritisation, provided a structured and participatory pathway for adapting an mHealth adherence app to the Nigerian context. The process ensured that core user needs guided technical decisions and that limited development resources were directed toward high-impact features. The adapted Lu Dedoo app reflects local preferences for functionality, language, and offline usability, and represents a promising, context-specific tool for improving ART adherence among AYALHIV.
Introduction
Adolescents and young adults living with HIV (AYALHIV) face persistent challenges with adherence to antiretroviral therapy (ART), resulting in increased risks of virologic failure, drug resistance, and poor health outcomes [1]. These challenges are especially pronounced in sub-Saharan Africa, where structural barriers such as stigma, limited psychosocial support, socioeconomic barriers such as low income, employment status, and health systems factors such as stockout of medical supplies and unavailability of trained healthcare personnel, compound individual and social vulnerabilities [1–4].
In Nigeria, Benue State is noted for having one of the highest HIV prevalence rates in the country at 4.9% [5]. Adolescents and young adults in this state constitute a priority demographic for intervention, as they represent approximately 60% of the population and exhibit the highest HIV prevalence. [5,6].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider technology & industry desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Olaposi Joseph Olatoregun, Lisa Hightow-Weidman, Marta Mulawa, Lauren Jennings, Jay Osi Samuels, Prosper Okonkwo, Catherine Orrell. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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