HIV: WhatsApp chatbot boosts knowledge among patients, Nigerian-Swiss study finds

A WhatsApp-based chatbot developed by Nigerian and Swiss researchers has improved practical HIV-related knowledge among people living with HIV in southwestern Nigeria, while earning high trust ratings from users, findings from a study involving 317 participants have shown.

The findings were presented at a dissemination programme at the College of Medicine, University College Hospital (UCH), Ibadan, where the project’s principal investigator, Professor Ademola Ajuwon, and Swiss research partner, Dr Christoph Pimmer, discussed the implications for digital health and HIV support services.

Titled “A Pilot Randomised Controlled Trial and an Interview Study to Evaluate a Chatbot for People Living with HIV in Nigeria”, the study assessed Ayo, a WhatsApp-based chatbot designed to provide HIV information and supplementary support beyond scheduled clinic visits.

The researchers recruited 317 participants from six healthcare facilities in southwestern Nigeria. Participants received either standard care alongside access to the chatbot or standard care alone. Assessments were conducted at recruitment and after 25 and 50 days. The study also included in-depth interviews with 23 chatbot users.

Presenting the findings, Pimmer said participants who used Ayo performed significantly better than those receiving standard care alone on a practical HIV knowledge measure. A separate HIV knowledge scale also showed improvement, although the difference was not statistically significant.

He added that participants who engaged more frequently with the chatbot, particularly its educational modules, tended to record greater knowledge gains.

The study found that users rated Ayo’s trustworthiness at approximately 4.4 out of five, while their perceived social connection with the chatbot scored about 4.33 out of five.

Some participants described the platform as a trusted friend, confidant or family member, citing its availability and non-judgemental approach to sensitive health concerns.

Pimmer said the findings suggested that digital tools could provide an additional source of information and support, particularly for people who experience difficulty discussing HIV openly because of stigma.

However, he noted that the relatively modest engagement with the chatbot’s educational content underscored the need to make digital health interventions more responsive to users’ preferences and daily routines.

Ajuwon called for future versions of the chatbot to include local-language options, particularly Yoruba and Nigerian Pidgin, to reach people who may struggle with English-language content.

He also recommended introducing audio and voice-based features to allow users to interact with the chatbot by speaking rather than typing, potentially improving accessibility for people with limited literacy.

The principal investigator urged developers to keep educational messages short, clear and simple to understand, noting that lengthy content could discourage engagement.

He further recommended strengthening practical features, particularly medication and appointment reminders, which were among the functions participants used most frequently.

Ajuwon stressed the importance of involving intended users in developing digital health tools to ensure that their content and features reflect real-world needs.

The researchers emphasised that Ayo should complement, not replace, clinic attendance, professional counselling or established HIV treatment services. They also stressed the need to provide accurate medical information and protect users’ privacy and confidentiality, given the sensitivity of HIV-related information.

The team called for further research to assess the chatbot’s effectiveness across different communities and healthcare settings and to identify ways to improve engagement with its educational content.

Funded by the Swiss National Science Foundation, the project provides early evidence that a carefully designed WhatsApp chatbot could strengthen HIV education and offer additional support to people living with the condition.

The researchers said wider adoption would depend on improving accessibility, ensuring the reliability of health information, safeguarding confidentiality and integrating digital tools with established healthcare services.