JMIR Publications

ABSTRACT

Background:

Latino sexual minority men (SMM) are disproportionally impacted by HIV. Uptake of pre-exposure prophylaxis (PrEP), an effective biomedical intervention to prevent HIV acquisition, is low in this group compared to White SMM. Mobile technology (mHealth) represents an innovative strategy to increase PrEP uptake among Latino SMM.

Objective:

This paper describes the qualitative process that led to the development of SaludFindr, a comprehensive HIV prevention mobile app that aims to increase PrEP uptake, HIV testing, and condom use by Latino SMM.

Methods:

We conducted 13 in-depth interviews with Latino SMM living in metropolitan Atlanta to explore the main barriers and facilitators to PrEP uptake in this group and analyze their overall opinions of potential SaludFindr app functionalities. To explore potential app functions, we used HealthMindr, an existing comprehensive HIV prevention app, as a template and added new proposed features intended to address the specific needs of this community.

Results:

We identified PrEP uptake barriers that are common among non-Latino groups, including low perceived PrEP eligibility, intersectional stigma, lack of insurance, cost concerns, and misconceptions about PrEP side effects. We also identified Latino-specific barriers that predominantly hinder access to existing services, including a scarcity of PrEP clinics located in Latino neighborhoods that are prepared to provide culturally-concordant services, limited availability of Spanish-language written information related to PrEP access, distrust of peers as credible sources of information, perceived ineligibility for low-cost services due to undocumented status, a fear of immigration authorities, and competing work obligations that prevent PrEP clinic attendance. The proposed app was very well accepted, with particularly high interest in features that facilitate PrEP access, including a tailored list of clinics that meet the community needs and a private platform where app users can gather reliable PrEP information.

Conclusions:

This study provides further evidence of the significant barriers to PrEP uptake that Latino SMM face and suggests that apps driven by a community-informed development process are a promising method to overcome some of those barriers.