Clinic-Integrated Smartphone App (JomPrEP) to Improve Uptake of HIV Testing and Pre-exposure Prophylaxis Among Men Who Have Sex With Men in Malaysia: Mixed Methods Evaluation of Usability and Acceptability

Abstract

Background HIV disproportionately affects men who have sex with men (MSM). In Malaysia, where stigma and discrimination toward MSM are high, including in health care settings, mobile health (mHealth) platforms have the potential to open new frontiers in HIV prevention. Objective We developed an innovative, clinic-integrated smartphone app called JomPrEP, which provides a virtual platform for Malaysian MSM to engage in HIV prevention services. In collaboration with the local clinics in Malaysia, JomPrEP offers a range of HIV prevention (ie, HIV testing and pre-exposure prophylaxis [PrEP]) and other support services (eg, referral to mental health support) without having to interface face to face with clinicians. This study evaluated the usability and acceptability of JomPrEP to deliver HIV prevention services for MSM in Malaysia. Methods In total, 50 PrEP-naive MSM without HIV in Greater Kuala Lumpur, Malaysia, were recruited between March and April 2022. Participants used JomPrEP for a month and completed a postuse survey. The usability of the app and its features were assessed using self-report and objective measures (eg, app analytics, clinic dashboard). Acceptability was evaluated using the System Usability Scale (SUS). Results The participants’ mean age was 27.9 (SD 5.3) years. Participants used JomPrEP for an average of 8 (SD 5.0) times during 30 days of testing, with each session lasting an average of 28 (SD 38.9) minutes. Of the 50 participants, 42 (84%) ordered an HIV self-testing (HIVST) kit using the app, of whom 18 (42%) ordered an HIVST more than once. Almost all participants (46/50, 92%) initiated PrEP using the app (same-day PrEP initiation: 30/46, 65%); of these, 16/46 (35%) participants chose PrEP e-consultation via the app (vs in-person consultation). Regarding PrEP dispensing, 18/46 (39%) participants chose to receive their PrEP via mail delivery (vs pharmacy pickup). The app was rated as having high acceptability with a mean score of 73.8 (SD 10.1) on the SUS. Conclusions JomPrEP was found to be a highly feasible and acceptable tool for MSM in Malaysia to access HIV prevention services quickly and conveniently. A broader, randomized controlled trial is warranted to evaluate its efficacy on HIV prevention outcomes among MSM in Malaysia. Trial Registration ClinicalTrials.gov NCT05052411; https://clinicaltrials.gov/ct2/show/NCT05052411 International Registered Report Identifier (IRRID) RR2-10.2196/43318

mHealth-Based Gamification Interventions Among Men Who Have Sex With Men in the HIV Prevention and Care Continuum: Systematic Review and Meta-Analysis

“…In addition, a secondary reference search was performed, yielding 1 more relevant record. Consequently, a total of 26 articles were included in the qualitative analysis [ 13 24-48 undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined ]. Furthermore, of the 26 articles, 6 RCTs were chosen for the meta-analysis [ 24 29 30 32 33 39 ].…”

“…These nonrandomized studies were not further included in the meta-analysis. We did not evaluate the study quality of the other 10 studies [ 26 27 31 37 38 40 41 44 46 47 ], as they were designed as study protocols or feasibility studies that did not report results for the outcomes of interest in our review.…”

“…The 10 RCTs under each outcome of interest in this review are listed in Table S5-1 in Multimedia Appendix 4 [ 13 24-39 41-48 undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined ]. The meta-analysis on the effect of gamification on CAS reduction contained 3 RCTs (total N=2138).…”

“…Authors of the initial publications were contacted when additional information was needed. Because of multiple classifications proposed for the term gamification, the components in each digital gamified intervention were analyzed through the lens of the Octalysis gamification framework [ 23 ], which comprises 8 core drives into which various gamification elements can be placed, namely, epic meaning and calling, development and accomplishment, empowerment creativity and feedback, ownership and possession, social influence and relatedness, scarcity and impatience, unpredictability and curiosity, and loss and avoidance (Table S3-2 in Multimedia Appendix 2 [ 13 24-48 undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined ]). Laine et al [ 49 ] mapped their interview results from schoolchildren to the Octalysis framework to better establish a digital gamification-based intervention for promoting active school transport.…”

Optimizing usability of a mobile health intervention for Spanish-speaking Latinx people with HIV through user-centered design: a post-implementation study

“… 19 This usability score is also comparable to other studies that have used the SUS to evaluate mHealth applications related to HIV care and prevention. 20–22 According to the SUS, most respondents stated that they would like to use CP frequently, the application is easy to use, has well-integrated features, is consistent, and that they felt confident using it. Responses to each item of the scale are reported in Table S1 .…”