Strengths and Limitations
sexual behaviors
The main strengths are that this study represents the first effort of evaluating an mHealth app in the field of HIV/AIDS in Vietnam. This study managed to test a new mobile intervention for individuals living with HIV that was conceptualized from a theoretical approach. We utilized codesign methods and theoretical models in the conceptualization of the assessed mobile app.Certain limitations also exist in our study. With respect to the confidentiality of HIV diagnosis and medical records, we were not able to preidentify the survey sample. Instead, the sample of participants was identified using convenience sampling and was subsequently randomized. The randomization method could not remove all underlying differences among participants assigned to the experimental or control conditions. There were also differences in educational levels, marital status, age, and duration of ART between the two groups. In addition, we acknowledge that ART outcomes will reduce transmission as well. However, we did not include sexual behaviors in our assessments, as we realized during the pilot trial that this remains a sensitive topic among Vietnamese people living with HIV, which could have affected the compliance to the app-based intervention since they were afraid of being traced and a loss of confidentiality. Furthermore, the follow-up period in our study was 3 months, while the ideal follow-up period should be 6 months or longer to fully determine the sustainability of treatment improvements.