Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Nov 20, 2022
Date Accepted: Jan 25, 2023
Clinic-Integrated Smartphone App (“JomPrEP”) to Improve Uptake of HIV Testing and PrEP among Men Who Have Sex with Men in Malaysia: Mixed Methods Evaluation of Usability and Acceptability
ABSTRACT
Background:
HIV disproportionately affects men who have sex with men (MSM). In Malaysia, where stigma and discrimination toward MSM are high, including in healthcare settings, mHealth platforms have the potential to open new frontiers in HIV prevention. In response, we developed an innovative, clinic-integrated smartphone app, called JomPrEP, which provides a virtual platform for Malaysian MSM to engage in HIV prevention services. In collaboration with the local clinics in Malaysia, JomPrEP offers a range of HIV prevention (i.e., HIV testing and pre-exposure prophylaxis; PrEP) and other support services (e.g., referral to mental health support) without having to interface face-to-face with the clinicians.
Objective:
This study evaluated the usability and acceptability of JomPrEP to deliver HIV prevention services for MSM in Malaysia.
Methods:
Fifty HIV-negative, PrEP-naive MSM in Greater Kuala Lumpur, Malaysia, were recruited between March and April 2022. Participants used JomPrEP for a month and completed a post-use survey. The usability of the app and its features were assessed using self-report and objective measures (e.g., app analytics, clinic dashboard). Acceptability was evaluated using the system usability scale (SUS).
Results:
Participants’ mean age was 27.9 (SD=5.3) years. Participants used JomPrEP, on average, 8 (SD=5.0) times during 30 days of testing, with each session lasting an average of 28 (SD=38.9) minutes. Among participants, 84.0% (42/50) ordered an HIV self-testing (HIVST) kit using the app, of whom 42.0% (18/43) ordered an HIVST more than once. Almost all participants (92.0%; 46/50) initiated PrEP using the app (same-day PrEP initiation: 65.2%; 30/46); of these, 34.8% (16/46) chose PrEP e-consultation via the app (vs. in-person consultation). Regarding PrEP dispensing, 39.1% (18/46) chose to receive their PrEP via mail delivery (vs. pharmacy pick-up). The app was rated as having high acceptability with a score of 73.8 (SD=10.1) on the SUS.
Conclusions:
JomPrEP was found to be a highly feasible and acceptable tool for MSM in Malaysia to access HIV prevention services quickly and conveniently. A broader, randomized controlled trial is warranted to evaluate its efficacy on HIV prevention outcomes among MSM in Malaysia. Clinical Trial: ClinicalTrials.gov NCT05052411; https://clinicaltrials.gov/ct2/show/NCT05052411
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