This paper is in the following e-collection/theme issue:

UConn CHASM 6th Annual Conference 2022: "Telehealth and Remote Care in a Post-Pandemic World" (54)

Published on in Vol 8, No 1 (2022): Jan-Dec

Preprints (earlier versions) of this paper are available at https://preprints.jmir.org/preprint/39358, first published .
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

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

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

Authors of this article:

Aviana O Rosen1 Author Orcid Image ;   Jeffrey A Wickersham2 ;   Frederick L Altice2 ;   Antoine Khati1 ;   Jeffrey Ralph Luces3 ;   Zhao Ni2 ;   Xin Zhou2 ;   Iskandar Azwa4 ;   Adeeba Kamarulzaman4 ;   Mohd Akbar Ab Halim4 ;   Roman Shrestha1
Article Authors Cited by (1) Tweetations Metrics

    Abstract

    1Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States

    2Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States

    3College of Allied Medical Professions, University of the Philippines, Manila, Philippines

    4Centre of Excellence for Research in AIDS, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

    Corresponding Author:

    Roman Shrestha, MPH, PhD

    Department of Allied Health Sciences

    University of Connecticut

    Koons Hall

    358 Mansfield Road U-1101

    Storrs, CT, 06269-1101

    United States

    Phone: 1 860 486 2446

    Email: roman.shrestha@uconn.edu


    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 health care. Mobile health (mHealth), particularly smartphone apps, is a promising and cost-effective strategy for reaching stigmatized and hard-to-reach populations like GBMSM and linking them to HIV prevention services (eg, HIV testing and pre-exposure prophylaxis [PrEP]), particularly in the context of COVID-19.

    Objective: This study aimed to adapt the HealthMindr app (Emory University), which was developed with GBMSM in the United States, to improve HIV testing and PrEP uptake for GBMSM in Malaysia.

    Methods: We conducted online focus group discussions (FGDs) between August and September 2021 with 20 GBMSM and 16 community stakeholders (eg, doctors, nurses, pharmacists, and nongovernmental organization 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 (University of California, Los Angeles) and analyzed to identify and interpret emerging themes.

    Results: The FGDs with GBMSM revealed 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 (eg, HIV and mental health). The key themes mostly focused on adaptation and refinement for the Malaysian context and were related to cultural and stylistic preferences (design and user interface), engagement strategies (reward systems, marketing campaigns, and reminders), and recommendations for new functions (enhanced communication options via chat and discussion forums) in a one-stop hub for all HIV prevention needs (HIV self-testing, PrEP, and postexposure prophylaxis) that minimize 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 the successful adaptation and refinement of the existing platform for optimal use in the Malaysian context.

    Conflicts of Interest: None declared.

    iproc 2022;8(1):e39358

    doi:10.2196/39358

    Keywords

    HIV; HIV prevention; pre-exposure prophylaxis; PrEP; HIV test; men who have sex with men; MSM; mHealth; eHealth; Malaysia; focus groups 

    Edited by S Pagoto; This is a non–peer-reviewed article. submitted 07.05.22; accepted 15.06.22; published 06.07.22

    Copyright

    ©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. Originally published in Iproceedings (https://www.iproc.org), 06.07.2022.

    This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on https://www.iproc.org/, as well as this copyright and license information must be included.