JMIR Publications

ABSTRACT

Background:

Sexual minority men with HIV are at increased risk of cardiovascular disease (CVD) and have been underrepresented in intervention research and in clinical trials.

Objective:

To explore patient’s and HIV care experts’ perceptions about HIV-related comorbidities and assess the usability and functionality of a virtual environment as CVD prevention education in Black and Latinx sexual minority men with HIV.

Methods:

This two-phase study is part of a pilot clinical trial to test acceptability and feasibility of a virtual environment as CVD prevention education in Black and Latinx sexual minority men with HIV. We qualitatively explored HIV comorbidities of concern and conducted usability and beta testing of the virtual environment.

Results:

In Phase 1, we found CVD risk factors included high blood pressure, heart attack, stroke, and diabetes. Cancer (prostate, colon, and others) was a common concern and so were the development of mental health conditions. In Phase 2, all participants completed the 12-item usability checklist with favorable feedback. Several themes emerged: 1) Mixed perceptions about health and HIV, 2) High risk for comorbid conditions, and 3) Virtual environment features. Sentiment resulting from beta-testing was favorable, but included constructive feedback for refinements that include diverse avatar representations.

Conclusions:

We identified several comorbid conditions of concern and findings carry significant implications for mitigating barriers to preventative health screenings in Black and Latinx sexual minority men with HIV given the shared risk factors between HIV and related comorbidities. Highly rated aspects of the virtual environment were anonymity, the ability to meet other patients who identify as gay or bisexual with HIV, and accessibility to CVD prevention education. Critical end-user feedback from beta-testing suggested more options for avatar customization in skin, hair, body representation. We will apply these recommendations and others in our next step to formally test the virtual environment as a novel modality to extend the reach of CVD prevention education to minoritized individuals that have been underrepresented in advancements in health equity and in clinical trials. Clinical Trial: clinical trial (NCT04061915)