Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States.
AIDS Program, Yale School of Medicine, New Haven, CT, United States.
JMIR Mhealth Uhealth. 2023 Feb 16;11:e44468. doi: 10.2196/44468.
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.
背景：艾滋病毒在男男性行为者（MSM）中不成比例地流行。在马来西亚，对 MSM 的污名化和歧视程度很高，包括在医疗保健环境中，移动健康（mHealth）平台有可能在 HIV 预防方面开辟新的前沿。
目的：我们开发了一种创新的、整合在诊所的智能手机应用程序，称为 JomPrEP，它为马来西亚的 MSM 提供了一个参与 HIV 预防服务的虚拟平台。与马来西亚当地诊所合作，JomPrEP 提供了一系列 HIV 预防（即 HIV 检测和暴露前预防 [PrEP]）和其他支持服务（例如，转介到心理健康支持），而无需与临床医生面对面接口。本研究评估了 JomPrEP 在马来西亚为 MSM 提供 HIV 预防服务的可用性和可接受性。
方法：在 2022 年 3 月至 4 月期间，共招募了 50 名在吉隆坡大都市区无 HIV 的 PrEP 初治 MSM。参与者使用 JomPrEP 一个月，并完成了使用后调查。使用自我报告和客观测量（例如，应用程序分析、诊所仪表板）评估应用程序及其功能的可用性。使用系统可用性量表（SUS）评估可接受性。
结果：参与者的平均年龄为 27.9（SD 5.3）岁。参与者在 30 天的测试期间平均使用 JomPrEP 8（SD 5.0）次，每次平均持续 28（SD 38.9）分钟。在 50 名参与者中，有 42 名（84%）使用该应用程序订购了 HIV 自我检测（HIVST）试剂盒，其中 18 名（42%）不止一次订购了 HIVST。几乎所有参与者（46/50，92%）都通过该应用程序开始接受 PrEP（同日 PrEP 起始：30/46，65%）；其中，16/46（35%）参与者选择通过该应用程序进行 PrEP 电子咨询（与面对面咨询相比）。关于 PrEP 的分配，有 18/46（39%）名参与者选择通过邮件投递（而不是药店取药）接收 PrEP。该应用程序的接受度很高，SUS 平均得分为 73.8（SD 10.1）。
结论：JomPrEP 被发现是马来西亚 MSM 快速方便地获得 HIV 预防服务的一种非常可行和可接受的工具。需要进行更大规模的随机对照试验来评估其在马来西亚 MSM 中预防 HIV 的效果。
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