“Un amigo secreto”: perceived acceptability of a chatbot for depression education, self-help and linkage to care among adolescents living with HIV in Peru

Adolescents living with HIV (ALWH) in Peru face significant mental health challenges, including a high prevalence of depression, exacerbated by limited access to mental health resources. This study explores the perceived acceptability of chatbots to support depression education, self-care, and referral among ALWH. Focus groups and interviews were conducted with 28 adolescents, 5 caregivers, and 5 HIV care personnel. A semi-structured interview guide assessed seven core chatbot acceptability constructs: affective attitude, ethics, burden, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy. Most participants expressed positive attitudes towards a potential mental health chatbot, highlighting the possibilities it could offer as a non-threatening and accessible source of information and support, offering immediate responses and facilitating a safe space for ALWH to communicate their needs in moments of isolation. Participants understood a potential chatbot's three main purposes and had confidence in their abilities to use one successfully. However, concerns were raised regarding a potential chatbot's inability to provide human empathy and potential privacy issues related to data security. Despite some reservations, participants generally believed that chatbots could effectively deliver educational content, promote self-help strategies, and serve as a bridge to professional care.