Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Mar 27, 2024
Date Accepted: Oct 14, 2024
Warning: This is an author submission that is not peer-reviewed or edited.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.
Exploring and Predicting Patterns of Pre-exposure Prophylaxis Adherence among Men Who Have Sex with Men: The Impact of mHealth Intervention
ABSTRACT
Background:
Pre-exposure prophylaxis (PrEP) is an effective strategy to reduce the risk of HIV infection. However, the efficacy of PrEP is highly dependent on adherence.
Objective:
Our study aimed to explore and predict the patterns of change in Pre-exposure prophylaxis (PrEP) adherence among Men who have sex with men (MSM), and evaluate the impact of the WeChat-based reminder intervention on adherence, thus providing more information for PrEP implementation strategies.
Methods:
In a randomized controlled longitudinal study of the PrEP demonstration project based on mHealth intervention, we used the Growth mixture model (GMM) to explore potential categories and longitudinal trajectories of adherence among MSM, and patterns of change in PrEP adherence were predicted and evaluated based on Decision tree.
Results:
The GMM identified 3 trajectories of adherence: Intermediate adherence group (N=34, 7.62%), Low adherence ascending group (N=126, 28.25%) and High adherence decline group (N=286, 64.13%). We found four factors and eight prediction rules, and the results showed that HIV knowledge score, education attainment, mHealth intervention, and HIV testing were key nodes in the patterns of change in adherence. The final model predicted low and intermediate adherence with an accuracy of 78.12%.
Conclusions:
WeChat-based reminder intervention was beneficial for adherence. A short set of questions and prediction rules that can be applied in future large-scale validation studies aimed at developing and validating a short adherence assessment tool and implementing it in PrEP practices among MSM. Clinical Trial: Chinese Clinical Trial Registration Number: ChiCTR190026414
Citation
