Liu Albert Y, Torres Thiago S, Alleyne Cat-Dancing, Vinson Janie, Bojan Kelly, Serrano Pedro Alonso, Oyedele Temitope, Garcia Amayvis, Enriquez-Bruce Elizabeth, Emmanuel Patricia, Jones Jeb, Muessig Kathryn E, Buchbinder Susan P, Sullivan Patrick, Hightow-Weidman Lisa B, Scott Hyman
Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, United States.
Department of Medicine, University of California San Francisco, San Francisco, CA, United States.
JMIR Hum Factors. 2025 May 29;12:e62830. doi: 10.2196/62830.
Young sexual minority men (YSMM) are disproportionately impacted by HIV in the United States. HIV or sexually transmitted infection (STI) testing rates and pre-exposure prophylaxis (PrEP) uptake are low in this priority population. Novel strategies are needed to increase access to HIV and STI prevention services among YSMM.
This study aims to describe the development and assess the feasibility and acceptability of LYNX, a mobile app to increase HIV testing and PrEP uptake among YSMM.
Informed by the Information-Motivation-Behavioral Skills model, the LYNX app was refined through 4 iterative focus groups in 2 US cities among YSMM aged 15 to 24 years. The LYNX app includes SexPro, an innovative tool that provides a personalized sexual health protection score, a sex diary to track sexual partners, HIV and STI testing information and reminders, access to home HIV and STI test kits, and geospatial-based testing and PrEP clinic site information. The refined app was then tested for feasibility and acceptability in a 2-month technical pilot. Baseline and 2-month follow-up assessments and exit interviews were completed. Self-reported app acceptability and use based on paradata were reported.
In iterative focus groups among 30 participants (age: mean 20, SD 3 years; Black: 12/30, 40%; Hispanic or Latinx: 13/30, 43%), the app's design was well-received. Participants recommended providing information on how the SexPro score was calculated and how they could improve their score, changes to the language in the sex diary tailored for YSMM, providing a chat feature to facilitate communication between staff and app users, and gamification features to increase overall youth engagement with the app. These recommendations were incorporated into the app. In the technical pilot among 17 participants (age: mean 22.4, SD 1.6 years; Black: 4/17, 24%; Hispanic or Latinx: 8/17, 47%), the mean system usability score was 70 out of 100, falling in the "good" range. Use of the app was high over the 2-month pilot (app opened an average of 8.5, SD 8.0 times with an average duration of 3.8, SD 3.2 min/session), indicating good feasibility. The most commonly used features included the testing feature (n=15, 100%), activity calendar (n=14, 93%), and diary (n=13, 86%). Overall, 11 (79%) participants were likely to continue using LYNX, and 10 (71%) participants were likely to recommend it to a friend. In exit interviews, there was a high level of acceptability of the content, interface, and features of the LYNX app.
Following a user-centered design approach, we tailored the LYNX app to increase HIV and STI testing and PrEP uptake among YSMM in the United States. Our positive findings support further testing of this mobile health tool in an upcoming effectiveness trial in broader youth populations.
ClinicalTrials.gov NCT03177512; https://clinicaltrials.gov/study/NCT03177512.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/10659.
在美国，年轻的性少数男性（YSMM）受艾滋病毒的影响尤为严重。这一重点人群的艾滋病毒或性传播感染（STI）检测率以及暴露前预防（PrEP）的使用率较低。需要新的策略来增加YSMM获得艾滋病毒和性传播感染预防服务的机会。
本研究旨在描述LYNX的开发过程，并评估其可行性和可接受性。LYNX是一款移动应用程序，旨在提高YSMM的艾滋病毒检测率和PrEP使用率。
基于信息-动机-行为技能模型，LYNX应用程序在美国两个城市针对15至24岁的YSMM通过4个迭代焦点小组进行了优化。LYNX应用程序包括SexPro，这是一种创新工具，可提供个性化的性健康保护评分、用于跟踪性伴侣的性日记、艾滋病毒和性传播感染检测信息及提醒、获取家用艾滋病毒和性传播感染检测试剂盒，以及基于地理空间的检测和PrEP诊所地点信息。然后，在为期2个月的技术试点中对优化后的应用程序进行了可行性和可接受性测试。完成了基线和2个月的随访评估以及退出访谈。报告了基于辅助数据的自我报告的应用程序可接受性和使用情况。
在30名参与者（年龄：平均20岁，标准差3岁；黑人：12/30，40%；西班牙裔或拉丁裔：13/30，43%）参与的迭代焦点小组中，该应用程序的设计受到好评。参与者建议提供有关SexPro评分如何计算以及如何提高评分的信息，针对YSMM对性日记中的语言进行修改，提供聊天功能以促进工作人员与应用程序用户之间的沟通，以及增加游戏化功能以提高年轻人对该应用程序的整体参与度。这些建议被纳入了应用程序。在17名参与者（年龄：平均22.4岁，标准差1.6岁；黑人：4/17，24%；西班牙裔或拉丁裔：8/17，47%）参与的技术试点中，系统可用性平均得分为70分（满分100分），属于“良好”范围。在为期2个月的试点中，该应用程序的使用率很高（应用程序平均打开8.5次，标准差8.0次，每次会话平均持续时间3.8分钟，标准差3.2分钟），表明可行性良好。最常用的功能包括检测功能（n = 15，100%）、活动日历（n = 14，93%）和日记（n = 13，86%）。总体而言，11名（79%）参与者可能会继续使用LYNX, 10名（71%）参与者可能会向朋友推荐它。在退出访谈中，参与者对LYNX应用程序的内容、界面和功能的接受度很高。
遵循以用户为中心的设计方法，我们对LYNX应用程序进行了定制，以提高美国YSMM中的艾滋病毒和性传播感染检测率以及PrEP使用率。我们的积极研究结果支持在即将开展的针对更广泛青年人群的有效性试验中对这种移动健康工具进行进一步测试。
ClinicalTrials.gov NCT03177512；https://clinicaltrials.gov/study/NCT03177512。
国际注册报告识别码（IRRID）：RR2-10.2196/10659。
