A Mobile Phone App to Support Adherence to Daily HIV Pre-exposure Prophylaxis Engagement Among Young Men Who Have Sex With Men and Transgender Women Aged 15 to 19 Years in Thailand: Pilot Randomized Controlled Trial
BackgroundWidespread smartphone use provides opportunities for mobile health HIV prevention strategies among at-risk populations. ObjectiveThis study aims to investigate engagement in a theory-based (information–motivation–behavioral skills model) mobile phone app...
| Principais autores: | , , , , , , , , , |
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| Formato: | Artigo |
| Idioma: | English |
| Publicado em: |
JMIR Publications
2022-04-01
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| coleção: | JMIR mHealth and uHealth |
| Acesso em linha: | https://mhealth.jmir.org/2022/4/e25561 |
| _version_ | 1827858384701882368 |
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| author | Surinda Kawichai Wipaporn Natalie Songtaweesin Prissana Wongharn Nittaya Phanuphak Tim R Cressey Juthamanee Moonwong Anuchit Vasinonta Chutima Saisaengjan Tanat Chinbunchorn Thanyawee Puthanakit |
| author_facet | Surinda Kawichai Wipaporn Natalie Songtaweesin Prissana Wongharn Nittaya Phanuphak Tim R Cressey Juthamanee Moonwong Anuchit Vasinonta Chutima Saisaengjan Tanat Chinbunchorn Thanyawee Puthanakit |
| author_sort | Surinda Kawichai |
| collection | DOAJ |
| description |
BackgroundWidespread smartphone use provides opportunities for mobile health HIV prevention strategies among at-risk populations.
ObjectiveThis study aims to investigate engagement in a theory-based (information–motivation–behavioral skills model) mobile phone app developed to support HIV pre-exposure prophylaxis (PrEP) adherence among Thai young men who have sex with men (YMSM) and young transgender women (YTGW) in Bangkok, Thailand.
MethodsA randomized controlled trial was conducted among HIV-negative YMSM and YTGW aged 15-19 years initiating daily oral PrEP. Participants were randomized to receive either youth-friendly PrEP services (YFS) for 6 months, including monthly contact with site staff (clinic visits or telephone follow-up) and staff consultation access, or YFS plus use of a PrEP adherence support app (YFS+APP). The target population focus group discussion findings and the information–motivation–behavioral skills model informed app development. App features were based on the 3Rs—risk assessment of self-HIV acquisition risk, reminders to take PrEP, and rewards as redeemable points. Dried blood spots quantifying of tenofovir diphosphate were collected at months 3 and 6 to assess PrEP adherence. Tenofovir diphosphate ≥350-699 fmol/punch was classified as fair adherence and ≥700 fmol/punch as good adherence. Data analysis on app use paradata and exit interviews were conducted on the YFS+APP arm after 6 months of follow-up.
ResultsBetween March 2018 and June 2019, 200 participants with a median age of 18 (IQR 17-19) years were enrolled. Overall, 74% (148/200) were YMSM; 87% (87/100) of participants who received YFS+APP logged in to the app and performed weekly HIV acquisition risk assessments (log-in and risk assessment [LRA]). The median duration between the first and last log-in was 3.5 (IQR 1.6-5.6) months, with a median frequency of 6 LRAs (IQR 2-10). Moreover, 22% (22/100) of the participants in the YFS+APP arm were frequent users (LRA≥10) during the 6-month follow-up period. YMSM were 9.3 (95% CI 1.2-74.3) times more likely to be frequent app users than YTGW (P=.04). Frequent app users had higher proportions (12%-16%) of PrEP adherence at both months 3 and 6 compared with infrequent users (LRA<10) and the YFS arm, although this did not reach statistical significance. Of the 100 participants in the YFS+APP arm, 23 (23%) were interviewed. The risk assessment function is perceived as the most useful app feature. Further aesthetic adaptations and a more comprehensive rewards system were suggested by the interviewees.
ConclusionsHigher rates of PrEP adherence among frequent app users were observed; however, this was not statistically significant. A short app use duration of 3 months suggests that they may be useful in establishing habits in taking daily PrEP, but not long-term adherence. Further studies on the specific mechanisms of mobile phone apps that influence health behaviors are needed.
Trial RegistrationClinicalTrials.gov NCT03778892; https://clinicaltrials.gov/ct2/show/NCT03778892 |
| first_indexed | 2024-03-12T12:55:05Z |
| format | Article |
| id | doaj.art-f71553efda49462cbc49f0e9f3439b5c |
| institution | Directory Open Access Journal |
| issn | 2291-5222 |
| language | English |
| last_indexed | 2024-03-12T12:55:05Z |
| publishDate | 2022-04-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR mHealth and uHealth |
| spelling | doaj.art-f71553efda49462cbc49f0e9f3439b5c2023-08-28T21:28:11ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222022-04-01104e2556110.2196/25561A Mobile Phone App to Support Adherence to Daily HIV Pre-exposure Prophylaxis Engagement Among Young Men Who Have Sex With Men and Transgender Women Aged 15 to 19 Years in Thailand: Pilot Randomized Controlled TrialSurinda Kawichaihttps://orcid.org/0000-0003-0189-4125Wipaporn Natalie Songtaweesinhttps://orcid.org/0000-0003-3440-732XPrissana Wongharnhttps://orcid.org/0000-0002-4245-0419Nittaya Phanuphakhttps://orcid.org/0000-0002-0036-3165Tim R Cresseyhttps://orcid.org/0000-0002-8106-0974Juthamanee Moonwonghttps://orcid.org/0000-0002-9840-2168Anuchit Vasinontahttps://orcid.org/0000-0002-5731-6968Chutima Saisaengjanhttps://orcid.org/0000-0003-4044-0951Tanat Chinbunchornhttps://orcid.org/0000-0001-6053-9436Thanyawee Puthanakithttps://orcid.org/0000-0002-0019-2183 BackgroundWidespread smartphone use provides opportunities for mobile health HIV prevention strategies among at-risk populations. ObjectiveThis study aims to investigate engagement in a theory-based (information–motivation–behavioral skills model) mobile phone app developed to support HIV pre-exposure prophylaxis (PrEP) adherence among Thai young men who have sex with men (YMSM) and young transgender women (YTGW) in Bangkok, Thailand. MethodsA randomized controlled trial was conducted among HIV-negative YMSM and YTGW aged 15-19 years initiating daily oral PrEP. Participants were randomized to receive either youth-friendly PrEP services (YFS) for 6 months, including monthly contact with site staff (clinic visits or telephone follow-up) and staff consultation access, or YFS plus use of a PrEP adherence support app (YFS+APP). The target population focus group discussion findings and the information–motivation–behavioral skills model informed app development. App features were based on the 3Rs—risk assessment of self-HIV acquisition risk, reminders to take PrEP, and rewards as redeemable points. Dried blood spots quantifying of tenofovir diphosphate were collected at months 3 and 6 to assess PrEP adherence. Tenofovir diphosphate ≥350-699 fmol/punch was classified as fair adherence and ≥700 fmol/punch as good adherence. Data analysis on app use paradata and exit interviews were conducted on the YFS+APP arm after 6 months of follow-up. ResultsBetween March 2018 and June 2019, 200 participants with a median age of 18 (IQR 17-19) years were enrolled. Overall, 74% (148/200) were YMSM; 87% (87/100) of participants who received YFS+APP logged in to the app and performed weekly HIV acquisition risk assessments (log-in and risk assessment [LRA]). The median duration between the first and last log-in was 3.5 (IQR 1.6-5.6) months, with a median frequency of 6 LRAs (IQR 2-10). Moreover, 22% (22/100) of the participants in the YFS+APP arm were frequent users (LRA≥10) during the 6-month follow-up period. YMSM were 9.3 (95% CI 1.2-74.3) times more likely to be frequent app users than YTGW (P=.04). Frequent app users had higher proportions (12%-16%) of PrEP adherence at both months 3 and 6 compared with infrequent users (LRA<10) and the YFS arm, although this did not reach statistical significance. Of the 100 participants in the YFS+APP arm, 23 (23%) were interviewed. The risk assessment function is perceived as the most useful app feature. Further aesthetic adaptations and a more comprehensive rewards system were suggested by the interviewees. ConclusionsHigher rates of PrEP adherence among frequent app users were observed; however, this was not statistically significant. A short app use duration of 3 months suggests that they may be useful in establishing habits in taking daily PrEP, but not long-term adherence. Further studies on the specific mechanisms of mobile phone apps that influence health behaviors are needed. Trial RegistrationClinicalTrials.gov NCT03778892; https://clinicaltrials.gov/ct2/show/NCT03778892https://mhealth.jmir.org/2022/4/e25561 |
| spellingShingle | Surinda Kawichai Wipaporn Natalie Songtaweesin Prissana Wongharn Nittaya Phanuphak Tim R Cressey Juthamanee Moonwong Anuchit Vasinonta Chutima Saisaengjan Tanat Chinbunchorn Thanyawee Puthanakit A Mobile Phone App to Support Adherence to Daily HIV Pre-exposure Prophylaxis Engagement Among Young Men Who Have Sex With Men and Transgender Women Aged 15 to 19 Years in Thailand: Pilot Randomized Controlled Trial JMIR mHealth and uHealth |
| title | A Mobile Phone App to Support Adherence to Daily HIV Pre-exposure Prophylaxis Engagement Among Young Men Who Have Sex With Men and Transgender Women Aged 15 to 19 Years in Thailand: Pilot Randomized Controlled Trial |
| title_full | A Mobile Phone App to Support Adherence to Daily HIV Pre-exposure Prophylaxis Engagement Among Young Men Who Have Sex With Men and Transgender Women Aged 15 to 19 Years in Thailand: Pilot Randomized Controlled Trial |
| title_fullStr | A Mobile Phone App to Support Adherence to Daily HIV Pre-exposure Prophylaxis Engagement Among Young Men Who Have Sex With Men and Transgender Women Aged 15 to 19 Years in Thailand: Pilot Randomized Controlled Trial |
| title_full_unstemmed | A Mobile Phone App to Support Adherence to Daily HIV Pre-exposure Prophylaxis Engagement Among Young Men Who Have Sex With Men and Transgender Women Aged 15 to 19 Years in Thailand: Pilot Randomized Controlled Trial |
| title_short | A Mobile Phone App to Support Adherence to Daily HIV Pre-exposure Prophylaxis Engagement Among Young Men Who Have Sex With Men and Transgender Women Aged 15 to 19 Years in Thailand: Pilot Randomized Controlled Trial |
| title_sort | mobile phone app to support adherence to daily hiv pre exposure prophylaxis engagement among young men who have sex with men and transgender women aged 15 to 19 years in thailand pilot randomized controlled trial |
| url | https://mhealth.jmir.org/2022/4/e25561 |
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