JMIR Publications

ABSTRACT

Background:

HIV disproportionately impacts young men who have sex with men (YMSM) in the United States (US). Uptake of evidence-based prevention strategies, including routine HIV testing and use of pre-exposure prophylaxis (PrEP), are suboptimal in this population. Novel methods for reaching YMSM are needed.

Objective:

To describe the development and evaluate the feasibility and acceptability of the MyChoices app, a mobile app designed to increase HIV testing and PrEP use among YMSM in the US.

Methods:

Based on Social Cognitive Theory, the MyChoices app was developed to increase HIV testing and PrEP uptake among YMSM using an iterative process. In 2017, “beta” theater testing was conducted in two US cities to garner feedback (N=4 groups, 28 YMSM). These findings were used to refine MyChoices, which was then tested for initial acceptability and usability in a technical pilot (N=11 YMSM). Baseline and 2-month post-baseline assessments and exit interviews were completed. Transcripts were coded using a deductive approach and thematic analysis was used to synthesize data; app acceptability and usage data are also reported.

Results:

The MyChoices app includes personalized recommendations for HIV testing frequency and PrEP use, information on types of HIV tests and PrEP, ability to search nearby for HIV testing and PrEP care sites, and ability to order free home HIV and STI test kits, condoms and lube. In theater testing, YMSM described that MyChoices appears useful and would recommend it to peers. Participants liked the “look and feel” of the app, and believed that the ability to search for and be “pinged” when near an HIV testing site would be beneficial. Some suggested that portions of the app felt repetitive, and preferred using casual language rather than formal or medicalized terms. Following theater testing, the MyChoices app was refined, and participants in the technical pilot used the app, on average, 5 times (range:1-9) over 2 months, with an average duration of 8.5 minutes per session. At 2-month follow up, the mean System Usability Scale (0-100) score was 71 (i.e., above-average). Over eighty percent reported MyChoices was useful, and 90% said they would recommend it to a friend. In exit interviews, there was a high level of acceptability for the content, interface and features.

Conclusions:

These data show initial acceptability and user engagement of the MyChoices app. If future studies demonstrate efficacy in increasing HIV testing and PrEP uptake, the app is scalable to reach YMSM across the US. Clinical Trial: clinicalTrials.gov: NCT03179319