Accepted for/Published in: JMIR Formative Research
Date Submitted: May 13, 2021
Date Accepted: Nov 16, 2021
Date Submitted to PubMed: Jan 6, 2022
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Game Plan for PrEP: A brief, web-based intervention to improve uptake and use of HIV pre-exposure prophylaxis (PrEP) and reduce alcohol use among gay and bisexual men
ABSTRACT
Background:
HIV pre-exposure prophylaxis (PrEP) has considerable potential for reducing incidence among high-risk groups, like gay, bisexual, and other men who have sex with men (GBM). However, PrEP’s effectiveness is closely linked with consistent use, and a variety of individual-level barriers, including alcohol use, could impede optimal uptake and use. Web-based interventions can encourage medication adherence, HIV prevention behaviors, and responsible drinking, and could help support PrEP care, particularly in resource-limited settings.
Objective:
We previously developed a website called Game Plan that was designed to encourage heavy drinking GBM to use HIV prevention methods and reduce their alcohol use, and was inspired by brief motivational interventions. This manuscript describes web-based content we designed for integration into Game Plan to help encourage PrEP uptake and consistent use among GBM. In this manuscript, we describe this content and its rationale.
Methods:
Like the original site, these components were developed iteratively, guided by a thorough user-centered design process involving (1) consultation with subject matter experts, (2) usability interviews and surveys, and (3) user experience surveys.
Results:
In addition to Game Plan’s preexisting content, the additional PrEP components provide: (1) specific, personal, and digestible feedback to users about their level of risk for HIV without PrEP and illustrates how much consistent PrEP use could reduce it and (2) personal feedback about their risk for common STIs to address low risk perceptions, (3) interactive content challenging common beliefs and misconceptions about PrEP to reduce stigma, (4) content confronting familiar PrEP and alcohol beliefs, and (5) a change planning module that allows users to select specific goals for starting and/or strategies for consistent PrEP use. Users can opt-into a weekly two-way SMS program that provides similar feedback over a 12 week period after using Game Plan and follows up on the goals they set.
Conclusions:
Research preliminarily testing the efficacy of these components in improving PrEP outcomes, including uptake, adherence, STI rates, and alcohol use, is currently ongoing. If supported, these components could provide a scalable tool that can be used in resource-limited settings in which face-to-face intervention is difficult.
Citation
