A randomized controlled trial of an mHealth intervention for increasing access to HIV testing and care among young cisgender men and transgender women: the mLab App study protocol

Abstract

Background The number of youth living with HIV in the United States (US) continues to rise, and racial, ethnic, and sexual minority youth including young men who have sex with men (YMSM) and young transgender women (YTGW) bear a disproportionate burden of the HIV epidemic. Due to social and healthcare system factors, many YMSM and YTGW do not seek HIV testing services and are therefore less likely to be aware that they are infected. Mobile health technology (mHealth) has the ability to increase uptake of HIV testing among these populations. Thus, the mLab App—which combines HIV prevention information with a mobile phone imaging feature for interpreting at-home HIV test results—was developed to improve testing rates and linkage to care among Black, Latino, and other YMSM and YTGW living in New York City and Chicago and their surrounding areas. Methods This study is a three-arm randomized controlled trial among YMSM and YTGW aged 18–29 years. Participants are randomized to either the mLab App intervention including HIV home test kits and standard of preventive care, standard of preventive care only, or HIV home test kits and standard of preventive care only. Discussion mHealth technology used for HIV prevention is capable of delivering interventions in real-time, which creates an opportunity to remotely reach users across the country to strengthen their HIV care continuum engagement and treatment outcomes. Specifically during the COVID-19 pandemic, mHealth technology combined with at-home testing may prove to be essential in increasing HIV testing rates, especially among populations at high-risk or without regular access to HIV testing. Trial registration This trial was registered with Clinicaltrials.gov (NCT03803683) on January 14, 2019.

Self-Testing as a Hope to Reduce HIV in Transgender Women—Literature Review

“…HIVST has been shown to be safe and effective in increasing HIV testing rates without affecting condom use, social protection, or treatment inclusion [ 65 , 66 ]. Home testing provides easy access for high-risk individuals who rarely get tested [ 13 ]. Global studies have also shown that no serious side effects associated with HIVST have been reported [ 41 , 67 , 68 ].…”

“…One study found that among those who had sought testing in the past, 47% preferred home testing over testing in a clinical setting. Acceptability of home testing was 90% among those who rarely tested, underscoring the importance of home testing, especially in at-risk populations who may not have access to clinic testing for a variety of reasons [ 13 , 70 ]. There is evidence that HIV testing at higher frequency is related to a lower risk of HIV infection and is an effective regimen for reducing HIV infection rates [ 71 , 72 , 73 ].…”

“…The number of youths living with HIV in the United States (US) is increasing, and the epidemic is growing among racial, ethnic, and sexual minorities. Reports show that 69% of new infections occur in young men who have sex with men (MSM) and young TGW, and the epidemic is more severe among black and Hispanic youth [ 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. HIV prevalence among TGW is estimated to be approximately 14.2%, which is higher compared to other vulnerable populations such as gay, bisexual, and other men who have sex with men (10.6%) [ 19 , 20 , 21 ].…”

Usability of a Mobile Health Technology for HIV Testing Among Sexual Minorities

“…Once accessed, users upload their completed OraQuick test, which provides real-time HIV results. [1] Usability was assessed using Post-Study System Usability Questionnaire (PSSUQ) and Health Information Technology Usability Evaluation Scale (Health-ITUES), both using a five-point Likert scale to rate system usefulness, information, and interface quality, with higher scores indicating better satisfaction and perceived usability. To examine the association between usability (PSSUQ and Health-ITUES) and user characteristics (e.g., age, education, health literacy), Pearson correlation was performed.…”

“…The novel mLab app combines HIV information with a mobile phone imaging feature for interpreting at-home HIV test results. [1] Despite the proliferation of mHealth in health care, many systems have not been rigorously evaluated. We aimed to evaluate the usability of the mLab app for HIV tests and examine how it relates to users' education levels and health literacy.…”