Interest in HIV Prevention Mobile Phone Apps: Focus Group Study With Sexual and Gender Minority Persons Living in the Rural Southern United States

Abstract

Background Mobile health (mHealth) interventions, including smartphone apps, have been found to be an effective means of increasing the uptake of HIV prevention tools, including HIV and sexually transmitted infection (STI) tests and pre-exposure prophylaxis. However, most HIV prevention mHealth apps tested in the United States have been tested among populations living in areas surrounding urban centers. Owing to reduced access to broadband internet and reliable cellular data services, it remains unclear how accessible and effective these interventions will be in rural areas. In addition, gay and bisexual men who have sex with men and gender minority populations in rural areas experience enhanced stigma when compared with their more urban counterparts, and these experiences might affect their willingness and interest in mHealth apps. Objective This study aimed to conduct online focus groups with men who have sex with men and transgender and gender diverse populations in the rural southern United States to assess their interest in mHealth HIV prevention apps and the features that they would be the most interested in using. Methods Focus group participants were recruited from a larger pool of sexual and gender minority respondents to a web-based research survey. The participants indicated that they would be willing to participate in an online focus group discussion. Focus groups were conducted via secure Zoom (Zoom Video Communications Inc) videoconferencing. During the focus group discussions, participants were asked to discuss their experiences with HIV and STI prevention and how these experiences were affected by living in a rural area. They were then shown screenshots of a new app to promote HIV and STI prevention among rural populations and asked to provide their opinions on the app’s features. The transcripts of the discussions were reviewed and coded using a constant comparative approach. Results A total of 6 focus groups were conducted with 26 participants. Most participants were cisgender gay and bisexual men who have sex with men (19/26, 73%); the remaining participants were transgender men (2/26, 8%), were nonbinary people (2/26, 8%), or had multiple gender identities (3/26, 12%). Participants reported numerous barriers to accessing HIV and STI prevention services and accurate information about HIV and STI prevention options. Overall, the participants reported a high degree of interest in mHealth interventions for HIV and STI prevention and suggested several recommendations for the features of an app-based intervention that would be the most useful for rural residents. Conclusions These focus group discussions indicate that rural residence is not a major barrier to mHealth HIV and STI prevention intervention implementation and that there is a high degree of interest in these approaches to HIV and STI prevention.

Rural‐urban differences in monkeypox behaviors and attitudes among men who have sex with men in the United States

“…Participants who lived in a county with an Index score of 0.0‐0.39 were coded as urban, while those who lived in a county with a score of 0.40‐1.00 were coded as rural. The 0.40 cutoff is used within the Index 18 and MSM health research 19–28 …”

“…The 0.40 cutoff is used within the Index 18 and MSM health research. [19][20][21][22][23][24][25][26][27][28] Six-month sexual behavior characteristics…”

HIV pre‐exposure prophylaxis awareness, practices, and comfort among urban and rural family medicine physicians

“…Participants were coded as rural if they had an Index score of 0.40‐1.00, and those as urban if they had a score of 0.00‐0.39. These ranges were based on the Index 14 and prior PrEP studies 15–19 …”

“…These ranges were based on the Index 14 and prior PrEP studies. [15][16][17][18][19] Sexual health care practices Participants answered if they had ever taken a sexual history with an adolescent patient (aged 13-18), ordered or recommended an HIV test to an adolescent patient, and ordered or recommended a sexually transmitted infection (STI) test to an adolescent patient within their current clinic (yes/no).…”

Development of an mHealth App to Support the Prevention of Sexually Transmitted Infections Among Black Men Who Have Sex With Men Engaged in Pre-exposure Prophylaxis Care in New Orleans, Louisiana: Qualitative User-Centered Design Study

“…Mobile health (mHealth) apps offering peer support are a promising solution to facilitate the implementation of risk reduction strategies and potentially reduce STI incidence among BMSM who are prescribed PrEP. Furthermore, there is a high degree of interest in such apps with STI prevention features among men who have sex with men in the Southern United States [12].…”