Use of smartphones for social and sexual networking among transgender women in South India: Implications for developing smartphone-based online HIV prevention interventions

Background: Smartphone use is increasing among transgender women (TGW), including those who engage in sex work. Current government-supported HIV prevention interventions focus on physical venue-based outreach among TGW, missing the opportunity to reach them through smartphone-based interventions. Objective: We examined the use of smartphones among TGW, especially in relation to social and sexual networking, and explored their perspectives on their willingness to use smartphone-based HIV prevention interventions. Materials and Methods: Through an exploratory descriptive-interpretive qualitative research design, we conducted 6 focus groups with a purposive sample of 30 TGW (70% in sex work) and 4 key informant in-depth interviews in Chennai and Hyderabad, India. Data were explored using framework analysis. Results: Through smartphones, TGW used social media (e.g., WhatsApp and Facebook) and dating applications for socialization, meeting sexual partners, and entertainment. Low-literacy TGW used voice or video messaging. TGW expressed interest in receiving short health-related videos and text messages on HIV, mental health, and gender transition. Conclusion: At-risk TGW could potentially be reached through smartphone-based online health promotion interventions, but those interventions need to be holistic – moving beyond HIV.