  The HIV/AIDS pandemic is a global issue that has unequally affected several
countries. Due to the complexity of this condition and the human drama it
represents to those most affected by it, several fields have contributed to
solving or at least alleviating this situation, and the information systems
(IS) field has not been absent from these efforts. With the importance of
antiretroviral therapy (ART) as a starting point, several initiatives in the IS
field have focused on ways to improve the adherence and effectiveness of this
therapy: mobile phone reminders (for pill intake and appointments), and mobile
interfaces between patients and health workers are popular contributions.
However, many of these solutions have been difficult to implement or deploy in
some countries in the Global South, which are among the most affected by this
pandemic. This paper presents one such case. Using a case-study approach with
an extreme-case selection technique, the paper studies an m-health system for
HIV patients in the Kalangala region of Uganda. Using Heeks' design-reality gap
model for data analysis, the paper shows that the rich interaction between
social context and technology should be considered a central concern when
designing or deploying such systems.
