mHealth Strategies Related to HIV Postexposure Prophylaxis Knowledge and Access: Systematic Literature Review, Technology Prospecting of Patent Databases, and Systematic Search on App Stores

Abstract

Background Globally, the number of HIV cases continue to increase, despite the development of multiple prevention strategies. New cases of HIV have been reported disproportionately more in men who have sex with men and other vulnerable populations. Issues such as internalized and structural homophobia prevent these men from accessing prevention strategies such as postexposure prophylaxis (PEP). Mobile health (mHealth) interventions are known to be one of the newest and preferred options to enhance PEP knowledge and access. Objective The aim of this study was to identify and analyze the mobile apps addressing PEP for HIV infections. Methods We conducted a descriptive exploratory study in 3 sequential phases: systematic literature review, patent analysis, and systematic search of app stores. For the systematic review, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines adapted for an integrative review in the databases of PubMed, Web of Knowledge, Scopus, Cochrane, Embase, Science Direct, Eric, Treasure, and CINAHL. The patent analysis was performed by exploring the databases of the Brazilian National Institute of Industrial Property, the United States Patent and Trademark Office, and the European Patent Office. For the systematic search, we analyzed mHealth apps related to HIV in 2 major app libraries, that is, Google Play Store and App Store. The apps were evaluated by name, characteristics, functions, and availability in iPhone operating system/Android phones. Results We analyzed 22 studies, of which 2 were selected for the final stage. Both studies present the use of apps as mHealth strategies aimed at improving the sexual health of men who have sex with men, and they were classified as decision support systems. The search in the patent databases showed only 1 result, which was not related to the topic since it was a drug intervention. In the app libraries, 25 apps were found and analyzed, with 15 (60%) apps available for Android systems but only 3 (12%) addressing PEP. In general, the apps inform about HIV and HIV prevention and treatment, with the focus users being health care providers, people with HIV, or the general population, but they have only limited features available, that is, mainly text, images, and videos. The 3 apps exclusively focusing on PEP were created by researchers from Brazilian universities. Conclusions Our review found no connection between the scientific studies, registered patents, and the available apps related to PEP; this finding indicates that these available apps do not have a theoretical or a methodological background in their creation. Thus, since the scientific knowledge on HIV is not translated into technological products, preventing the emergence of new infections, especially in the more vulnerable groups, is difficult. In the future, researchers and the community must work in synergy to create more mHealth tools aimed at PEP.

Barreiras de acesso à profilaxia pós-exposição ao HIV: estudo de caso

“…(16,17) Um dos temas recorrentes das entrevistas foi a falta de automação do processo de acesso a PEP, ainda buro-crático e analógico. Ao buscar por estratégias de eHealth ou mHealth sobre o tema, uma revisão (18) recente mostrou que existem muito poucas iniciativas dedicadas exclusivamente ao PEP, pois a maioria dos aplicativos aborda aspectos genéricos do HIV. As análises de objetivo e conteúdo mostram que esses aplicativos são muito semelhantes às estratégias tradicionais (livretos e sites) por usarem pouco ou nada da ampla gama de ferramentas que um smartphone pode oferecer.…”

Mobile Apps for Sexual and Reproductive Health Education: a Systematic Review and Quality Assessment

“…The vast majority of studies focused on (a) women [25, 32, 33, 48•, 49, 52, 58] or more specifically, pregnancy and the postpartum period [26,29]. Other studies concentrated on (b) children [23,29], adolescents and young people [23, 29, 30, 31•, 50••, 59], (c) men [28] or men who have sex with men (MSM) [5] and (d) healthcare workers and/or patients [1•, 27]. There were also studies conducted on (e) adults [24,54] and (f) people that were deemed healthy [56] as well as (g) people in general [51…”

“…One App is the smartphone app HealthMindr available in English. The app contained tools which help with self-assessment [5]. It recommends prevention strategies to the users and assists them in ordering condoms and HIV self-tests [5].…”

“…With interactive components such as gamifications (e.g. quizzes), scenarios as well as role plays, it aims to provide same-sex attracted young males with helpful knowledge and skills to reduce their sexual risk behaviour and the risk of them contracting a sexual transmitted infection (STI) [5][6][7][8].…”

Remote Monitoring Systems for Patients With Chronic Diseases in Primary Health Care: Systematic Review

“…Still, the articles that focused on evaluations were, as already mentioned, only conceptual models that still lacked proof and real-world evidence. Despite all the studies and results analyzed, there is still a dearth of scientific consistency in the development and implementation process of these interventions and devices [42,43]. According to Gagnon et al [44], the success of an intervention linked to telecare lies in the implementation process.…”