Assessing mobile technology use and mHealth acceptance among HIV-positive men who have sex with men and transgender women in Malaysia

Krishnan, Archana; Weikum, Damian; Cravero, Claire; Kamarulzaman, Adeeba; Altice, Frederick L.

doi:10.1371/journal.pone.0248705

Cited by 10 publications

(7 citation statements)

References 32 publications

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“…For example, over half of our participants were university graduates, compared with only one-sixth among the general adult population in Malaysia [ 72 ]. Men who have sex with men in Malaysia’s capital, however, are typically more educated, which perhaps makes the sample more representative of urban men who have sex with men in Malaysia; our findings on participants’ educational status are consistent with previous studies conducted among men who have sex with men in the region [ 49 , 71 ]. The educational level of our sample may explain the high level of interest in mHealth and the acceptability of mHealth interventions, as a higher level of education likely facilitates greater technology literacy.…”

Section: Discussionsupporting

confidence: 89%

“…While this study focused on HIV prevention behavior, knowledge, and access to services among HIV-negative Malaysian men who have sex with men, mHealth-based health intervention strategies can potentially also play an important role among HIV-positive men who have sex with men, for instance, by encouraging adherence to antiretroviral therapy and increasing retention in the HIV-care cascade [ 70 ]. High rates of mHealth acceptability have been reported in HIV-positive men who have sex with men and transgender women in Malaysia, for receiving HIV-related and sexual health information, assessing sexual and health behaviors, and receiving reminders to take HIV medications [ 71 ].…”

Section: Discussionmentioning

confidence: 99%

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Mobile Health Technology Use and the Acceptability of an mHealth Platform for HIV Prevention Among Men Who Have Sex With Men in Malaysia: Cross-sectional Respondent-Driven Sampling Survey

Shrestha¹,

Maviglia²,

Altice³

et al. 2022

J Med Internet Res

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Background The growth in mobile technology access, utilization, and services holds great promise in facilitating HIV prevention efforts through mobile health (mHealth) interventions in Malaysia. Despite these promising trends, there is a dearth of evidence on the use of mHealth platforms that addresses HIV prevention among Malaysian men who have sex with men. Objective The goal of this study was to gain insight into (1) access and utilization of communication technology (eg, landline phone, internet, mobile phone), (2) acceptability of mHealth-based interventions for HIV prevention services, and (3) preferences regarding the format and frequency of mHealth interventions among Malaysian men who have sex with men. Methods We conducted a cross-sectional survey with Malaysian men who have sex with men between July 2018 and March 2020. Participants were recruited using respondent-driven sampling in the Greater Kuala Lumpur region of Malaysia. We collected information on demographic characteristics, HIV risk-related behaviors, access to and the frequency of use of communication technology, and acceptability of using mHealth for HIV prevention using a self-administered questionnaire with a 5-point scale (1, never; 2, rarely; 3, sometimes; 4, often; 5, all the time). Results A total of 376 men participated in the survey. Almost all respondents owned or had access to a smartphone with internet access (368/376, 97.9%) and accessed the internet daily (373/376, 99.2%), mainly on a smartphone (334/376, 88.8%). Participants on average used smartphones primarily for social networking (mean 4.5, SD 0.8), followed by sending or receiving emails (mean 4.0, SD 1.0), and searching for health-related information (mean 3.5, SD 0.9). There was high acceptance of the use of mHealth for HIV prevention (mean 4.1, SD 1.5), including for receiving HIV prevention information (345/376, 91.8%), receiving medication reminders (336/376, 89.4%), screening and monitoring sexual activity (306/376, 81.4%) or illicit drug use (281/376, 74.7%), and monitoring drug cravings (280/376, 74.5%). Participants overwhelmingly preferred a smartphone app over other modalities (eg, text, phone call, email) for engaging in mHealth HIV prevention tools. Preference for app notifications ranged from 186/336 (53.9%), for receiving HIV prevention information, to 212/336 (69.3%), for screening and monitoring sexual activity. Acceptance of mHealth was higher for those who were university graduates (P=.003), living in a relationship with a partner (P=.04), engaged in sexualized drug use (P=.01), and engaged in receptive anal sex (P=.006). Conclusions Findings from this study provide support for developing and deploying mHealth strategies for HIV prevention using a smartphone app in men who have sex with men—a key population with suboptimal engagement in HIV prevention and treatment.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Mobile Health Technology Use and the Acceptability of an mHealth Platform for HIV Prevention Among Men Who Have Sex With Men in Malaysia: Cross-sectional Respondent-Driven Sampling Survey

Shrestha¹,

Maviglia²,

Altice³

et al. 2022

J Med Internet Res

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“…(4, 6) These factors along with a lack of trust in the health care system were echoed in the result of similar studies involving transgender women from within the country (2, 6, 45)and other parts of the globe. (46-49)…”

Section: Discussionmentioning

confidence: 99%

“…Laws and policies that are discriminatory and punitive are also believed to be responsible for pushing this community away from health care services and undermining public health efforts (4,6). These factors along with a lack of trust in the health care system were echoed in the result of similar studies involving transgender women from within the country(2,6,45)and other parts of the globe (46)(47)(48)(49). The barriers and facilitators to safe sexual practices particular in relation to oral transmission of STIs were also explored.…”

mentioning

confidence: 99%

Exploring the barriers and enablers of oral health care utilization and safe oral sex behaviour among Transgender women of Malaysia: a qualitative study

Telang,

Rashid,

Cotter

2024

Preprint

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Background: Transgender women in Malaysia are vulnerable and marginalized. They experience unique social and interpersonal challenges that contribute to relatively unmet health care needs thereby increasing their risk of acquiring HIV and sexually transmitted infections (STIs). With research pertaining to oral health of transgender women being sparse in literature, this study aimed to understand their experiences by exploring the barriers and enablers of oral health care utilization as well as safe sexual behaviour relating to oral transmission of STIs among Transgender women. Methods: Semi structured in-depth interviews (n=20) with a group of urban dwelling transgender women (mean age= 39.8 years) in Northern Malaysia and Focus group discussion (n=7) with key informants was conducted to gain insights into the needs of the community. Participants were recruited through a snow-balling method of sampling with the help of transgender women community workers. The data obtained was coded and transcribed and subjected to thematic analysis to interpret and derive major themes and subthemes. Community advocates were involved in planning of the study. Results: All of participants reported experiencing high levels of stigma and discrimination in daily life. Routine engagement in oral sex practices (100%, n=20) was reported with multiple partners (60%, n=12) with a perceived low level of risk of transmission of STIs through this practice (80%, n=16). Nighty percent (n=18) never used barriers or inconsistently used them during oral sexual practices. Additionally, low utilization of dental services was reported with 80% (n=16) not having visited a dentist in the past 12 months or seeking self-medication or unprofessional care. The themes that emerged from the qualitative analysis were key to understanding the experiences of the community. Conclusion: The results identified gaps in awareness of oral transmission of STIs among the transgender women. The importance of social support in positively influencing health promotion as well as improving health care and dental care utilization was highlighted. The development of an educational intervention is proposed as an instrument to address these gaps and provide support.

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“…A recent survey of young MSM between the ages of 18 and 24 years found that approximately 70% were willing to participate in a web-based or mobile HIV prevention program, whereas only 1% would attend in-person programs exclusively [ 33 ]. As the access to and use of digital technologies do not appear to differ by mental health burden or HIV risk [ 42 , 43 ], mHealth may be a particularly attractive option for engaging underrepresented groups in settings where services are scarce.…”

Section: Introductionmentioning

confidence: 99%

Feasibility, Acceptability, and Design of a Mobile Ecological Momentary Assessment for High-Risk Men Who Have Sex With Men in Hanoi, Vietnam: Qualitative Study

Trang¹,

Le²,

Brown³

et al. 2022

JMIR Form Res

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Background Men who have sex with men (MSM) are at a disproportionate risk for HIV infection and common mental disorders worldwide. In the context of HIV, common mental disorders are important and are frequent drivers of suboptimal prevention and treatment outcomes. Mobile ecological momentary assessments (EMAs), or the repeated sampling of people’s behaviors and psychological states in their daily lives using mobile phones, can clarify the triggers and HIV-related sequelae of depressive-anxious symptoms and contribute toward the design of ecological momentary interventions (EMIs) that cater to the contextually varying needs of individuals to optimize prevention and treatment outcomes. Objective This study aims to characterize the feasibility and acceptability of mobile EMA among high-risk MSM in Hanoi, Vietnam. It aims to evaluate the perceived relevance, usability, and concerns of this group with regard to the content and delivery of mobile EMA and the potential of leveraging such platforms in the future to deliver EMIs. Methods Between January and April 2018, a total of 46 participants were recruited. The participants completed 6 to 8 mobile EMA surveys daily for 7 days. Surveys occurred once upon waking, 4 to 6 times throughout the day, and once before sleeping. All surveys queried participants’ perceived safety, social interactions, psychological state, and mental health symptoms. The morning survey further queried on sleep and medication use within the past 24 hours, whereas the night survey queried on sexual activity and substance use and allowed participants to share an audio recording of a stressful experience they had that day. At the end of the week, participants were interviewed about their experiences with using the app. Results Participants completed an average of 21.7 (SD 12.7) prompts over the 7-day period. Excluding nonresponders, the average compliance rate was 61.8% (SD 26.6%). A thematic analysis of qualitative interviews suggested an overall positive reception of the app and 5 recurring themes, which were centered on the relevance of psychological and behavioral items to daily experiences (eg, mental health symptoms and audio recording), benefits of using the app (eg, increased self-understanding), worries and concerns (eg, privacy), usability (eg, confusion about the interface), and recommendations for future design (eg, integrating more open-ended questions). Conclusions Mobile EMA is feasible and acceptable among young MSM in Vietnam; however, more research is needed to adapt EMA protocols to this context and enhance compliance. Most participants eagerly provided information about their mental health status and daily activities. As several participants looked toward the app for further mental health and psychosocial support, EMIs have the potential to reduce HIV and mental health comorbidity among MSM.

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Assessing mobile technology use and mHealth acceptance among HIV-positive men who have sex with men and transgender women in Malaysia

Cited by 10 publications

References 32 publications

Mobile Health Technology Use and the Acceptability of an mHealth Platform for HIV Prevention Among Men Who Have Sex With Men in Malaysia: Cross-sectional Respondent-Driven Sampling Survey

Mobile Health Technology Use and the Acceptability of an mHealth Platform for HIV Prevention Among Men Who Have Sex With Men in Malaysia: Cross-sectional Respondent-Driven Sampling Survey

Exploring the barriers and enablers of oral health care utilization and safe oral sex behaviour among Transgender women of Malaysia: a qualitative study

Feasibility, Acceptability, and Design of a Mobile Ecological Momentary Assessment for High-Risk Men Who Have Sex With Men in Hanoi, Vietnam: Qualitative Study

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