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Accepted for/Published in: iProceedings

Date Submitted: May 7, 2022
Date Accepted: Jun 15, 2022

The final, peer-reviewed published version of this preprint can be found here:

Adaptation of a Theory-Based, Clinic-Affiliated Smartphone App to Improve HIV Testing and Pre-exposure Prophylaxis Uptake Among Gay, Bisexual, and Other Men Who Have Sex With Men in Malaysia

Rosen AO, Wickersham JA, Altice FL, Khati A, Luces JR, Ni Z, Zhou X, Azwa I, Kamarulzaman A, Ab Halim MA, Shrestha R

Adaptation of a Theory-Based, Clinic-Affiliated Smartphone App to Improve HIV Testing and Pre-exposure Prophylaxis Uptake Among Gay, Bisexual, and Other Men Who Have Sex With Men in Malaysia

iProc 2022;8(1):e39358

DOI: 10.2196/39358

Adaptation of a theory-based clinic-affiliated smartphone app to improve HIV testing and pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in Malaysia

  • Aviana O. Rosen; 
  • Jeffrey A. Wickersham; 
  • Frederick L. Altice; 
  • Antoine Khati; 
  • Jeffrey Ralph Luces; 
  • Zhao Ni; 
  • Xin Zhou; 
  • Iskandar Azwa; 
  • Adeeba Kamarulzaman; 
  • Mohd Akbar Ab Halim; 
  • Roman Shrestha

ABSTRACT

Background:

In Malaysia, HIV disproportionately affects gay, bisexual, and other men who have sex with men (GBMSM). Homosexuality and substance use are criminalized in Malaysia, making GBMSM bear multilevels of social stigma and discrimination, including in healthcare. mHealth, particularly smartphone applications, are a promising and cost-effective strategy to reach stigmatized and hard-to-reach populations, like GBMSM, and link them to HIV prevention services (e.g., HIV testing, pre-exposure prophylaxis; PrEP), particularly in the context of COVID-19.

Objective:

This study aimed to adapt the HealthMindr app, developed with GBMSM in the U.S., to improve HIV testing and PrEP uptake for GBMSM in Malaysia.

Methods:

We conducted online focus group discussions (FGDs) between August-September 2021 with 20 GBMSM and 16 community stakeholders (e.g., doctors, nurses, pharmacists, NGO staff). Participants were asked questions regarding their preferences for functions and features in mHealth apps among GBMSM, and suggestions for adapting the HealthMindr app to the Malaysian context. Each session was digitally recorded and transcribed. Transcripts were inductively coded using Dedoose software and analyzed to identify and interpret emerging themes.

Results:

The FGDs with GBMSM stated preferences for interfacing with apps to access HIV testing, PrEP, and counseling services. Stakeholders showed strong interest in using the app-based platform to deliver integrated care (e.g., HIV, mental health). Key themes mostly focused on adaptation and refinement for the Malaysian context and were related to cultural and stylistic preferences (design, user interface), engagement strategies (reward systems, marketing campaigns, reminders), and recommendation for new functions (enhanced communication options via chat, discussion forum), a one-stop-hub for all HIV prevention needs (HIV self-testing, PrEP, post-exposure prophylaxis), minimizing privacy and confidentiality risks.

Conclusions:

Our data suggest that a tailored HIV-prevention app would be acceptable for GBMSM in Malaysia. The findings provided detailed recommendations for successful adaptation and refinement of the existing platform for optimal use in the Malaysian context.


 Citation

Please cite as:

Rosen AO, Wickersham JA, Altice FL, Khati A, Luces JR, Ni Z, Zhou X, Azwa I, Kamarulzaman A, Ab Halim MA, Shrestha R

Adaptation of a Theory-Based, Clinic-Affiliated Smartphone App to Improve HIV Testing and Pre-exposure Prophylaxis Uptake Among Gay, Bisexual, and Other Men Who Have Sex With Men in Malaysia

iProc 2022;8(1):e39358

DOI: 10.2196/39358

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© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.