JMIR Publications

ABSTRACT

Background:

Cisgender men who have sex with men and transgender people (MSM/TGP) who use methamphetamine are disproportionately impacted by HIV acquisition. Pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV, and interventions that support PrEP persistence and adherence should be evaluated among MSM/TGP who use methamphetamine.

Objective:

We conducted formative work to inform the development of text messaging and peer navigation interventions to support PrEP persistence and adherence among MSM/TGP who use methamphetamine. In this paper, we describe how the findings from these focus groups and interviews were used to refine the study interventions and protocol for the “Hit Me Up” study (HIV Prevention in Methamphetamine Users).

Methods:

Between October 2017 and March 2018, we conducted two focus groups and three in-depth interviews with MSM/TGP who use methamphetamine or who have worked with people who use methamphetamine. During these formative activities, we asked participants about their opinions on the proposed interventions, education and recruitment materials, and study design. Our conversations focused on how we could develop peer navigation and text messaging interventions that would be culturally appropriate and acceptable to MSM/TGP who use methamphetamine. Transcripts were reviewed by two authors who performed a retrospective content analysis to describe which specific opinions and recommendations influenced protocol development and the refinement of the interventions.

Results:

Overall, participants thought MSM/TGP would be interested in participating in the study, although they expected recruitment and retention to be challenging. Participants thought that the peer navigator should be someone who is non-judgmental, has experience with people who use methamphetamine, and is patient and flexible. There was consensus that three text messages per day were appropriate, adherence reminders should be straightforward, all messages should be non-judgmental, and participants should be able to tailor the timing and content of the text messages. These suggestions were incorporated into the study interventions via the hiring and training process and development of the text library, platform selection, and customizability of messages.

Conclusions:

It is important to include the opinions and insights of populations most impacted by HIV to develop PrEP interventions with the greatest chance of success. Our formative work generated several recommendations that were incorporated into the interventions and protocol development for our ongoing study. Clinical Trial: ClinicalTrials.gov NCT03584282