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DOT 日记：利用人工智能和电子性日记开发一款新型移动应用程序，以衡量和支持男男性行为者中使用 PrEP 的依从性。

DOT Diary: Developing a Novel Mobile App Using Artificial Intelligence and an Electronic Sexual Diary to Measure and Support PrEP Adherence Among Young Men Who Have Sex with Men.

机构信息

Bridge HIV, San Francisco Department of Public Health, 25 Van Ness Avenue, Suite 100, San Francisco, CA, 94102, USA.

Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.

出版信息

AIDS Behav. 2021 Apr;25(4):1001-1012. doi: 10.1007/s10461-020-03054-2. Epub 2020 Oct 12.

DOI:10.1007/s10461-020-03054-2
PMID:33044687
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7979437/
Abstract

Young men who have sex with men (YMSM) are highly vulnerable to HIV. While pre-exposure prophylaxis (PrEP) has demonstrated effectiveness, adherence has been low among YMSM and difficult to measure accurately. In collaboration with a healthcare company, we configured an automated directly-observed therapy (aDOT) platform for monitoring and supporting PrEP use. Based on interest expressed in focus groups among 54 YMSM, we combined aDOT with an electronic sexual diary to provide feedback on level of protection during sex and to motivate app use. In an 8-week optimization pilot with 20 YMSM in San Francisco and Atlanta, the app was found to be highly acceptable, with median System Usability Scale scores in the "excellent" range (80/100). App use was high, with median PrEP adherence of 91% based on aDOT-confirmed dosing. Most (84%) participants reported the app helped with taking PrEP. These promising findings support further evaluation of DOT Diary in future effectiveness studies.

摘要

男男性行为者（MSM）极易感染艾滋病毒。虽然暴露前预防（PrEP）已被证明有效，但 MSM 的用药依从性一直很低，且难以准确衡量。我们与一家医疗保健公司合作，为监测和支持 PrEP 使用配置了一个自动化直接观察治疗（aDOT）平台。基于对 54 名 MSM 进行的焦点小组中表达的兴趣，我们将 aDOT 与电子性日记相结合，以提供性行为期间的保护水平反馈，并激励应用程序的使用。在旧金山和亚特兰大的 20 名 MSM 参与的为期 8 周的优化试点中，该应用程序被认为具有高度的可接受性，中位系统可用性量表评分在“优秀”范围内（80/100）。该应用程序的使用频率很高，根据 aDOT 确认的剂量，PrEP 的平均用药依从性为 91%。大多数（84%）参与者表示该应用程序有助于服用 PrEP。这些有希望的发现支持在未来的有效性研究中进一步评估 DOT 日记。

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[1]
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NPJ Digit Med. 2025-6-11

[2]
Qualitative Results from a Pilot Study of an Automated Directly Observed Therapy Intervention Using Artificial Intelligence with Conditional Economic Incentives among Young Adults with HIV.

AIDS Behav. 2025-5-10

[3]
The mChoice App, an mHealth Tool for the Monitoring of Preexposure Prophylaxis Adherence and Sexual Behaviors in Young Men Who Have Sex With Men: Usability Evaluation.

JMIR Hum Factors. 2025-2-28

[4]
Acceptability of an automated directly observed therapy (DOT) application for PrEP adherence support among young men who have sex with men: a qualitative exploration.

AIDS Care. 2024-11

[5]
Using an interactive web application to identify pre-exposure prophylaxis adherence among men who have sex with men.

Int J Clin Health Psychol. 2024

[6]
Adapting mHealth Interventions (PrEPmate and DOT Diary) to Support PrEP Retention in Care and Adherence Among English and Spanish-Speaking Men Who Have Sex With Men and Transgender Women in the United States: Formative Work and Pilot Randomized Trial.

JMIR Form Res. 2024-3-27

[7]
Results From a Pilot Study of an Automated Directly Observed Therapy Intervention Using Artificial Intelligence With Conditional Economic Incentives Among Young Adults With HIV.

J Acquir Immune Defic Syndr. 2024-6-1

[8]
Youth Ending the HIV Epidemic (YEHE): Protocol for a pilot of an automated directly observed therapy intervention with conditional economic incentives among young adults with HIV.

PLoS One. 2023

[9]
Scaling up delivery of HIV services in Africa through harnessing trends across global emerging innovations.

Front Health Serv. 2023-10-31

[10]
The Impact of Generative Conversational Artificial Intelligence on the Lesbian, Gay, Bisexual, Transgender, and Queer Community: Scoping Review.

J Med Internet Res. 2023-12-6

本文引用的文献

[1]
Pharmacokinetics of Coencapsulated Antiretrovirals with Ingestible Sensors.

AIDS Res Hum Retroviruses. 2020-1

[2]
A Mobile Application to Collect Daily Data on Preexposure Prophylaxis Adherence and Sexual Behavior Among Men Who Have Sex With Men: Use Over Time and Comparability With Conventional Data Collection.

Sex Transm Dis. 2019-6

[3]
Vortioxetine for attention deficit hyperactivity disorder in adults: A randomized, double-blind, placebo-controlled, proof-of-concept study.

J Psychopharmacol. 2019-3-7

[4]
Ending the HIV Epidemic: A Plan for the United States.

JAMA. 2019-3-5

[5]
Developing a Mobile App (LYNX) to Support Linkage to HIV/Sexually Transmitted Infection Testing and Pre-Exposure Prophylaxis for Young Men Who Have Sex With Men: Protocol for a Randomized Controlled Trial.

JMIR Res Protoc. 2019-1-25

[6]
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Int J Environ Res Public Health. 2018-12-13

[7]
Effect of self-monitoring on long-term patient engagement with mobile health applications.

PLoS One. 2018-7-26

[8]
Intracellular Tenofovir-Diphosphate and Emtricitabine-Triphosphate in Dried Blood Spots following Directly Observed Therapy.

Antimicrob Agents Chemother. 2017-12-21

[9]
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Clin Infect Dis. 2018-1-6

[10]
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JAMA Pediatr. 2017-11-1

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