Testing of the Smartphone App to Enhance HIV Prevention Cascade Among Malaysian MSM

Studies

Study First Submitted Date 2021-08-25
Study First Posted Date 2021-09-14
Last Update Posted Date 2023-05-23
Start Month Year October 2023
Primary Completion Month Year January 2025
Verification Month Year May 2023
Verification Date 2023-05-31
Last Update Posted Date 2023-05-23

Detailed Descriptions

Sequence: 20779499
Description mHealth is a promising and cost-effective strategy to reach stigmatized and hard-to-reach populations and link them to care. Leveraging mHealth reduces individuals' discomfort and distrust of disclosing risk behaviors to providers, providers' low cultural competency for working with individuals of diverse sexual identities, and bypasses barriers to care for marginalized populations, – all features crucial for HIV prevention in MSM in Malaysia. Results from the investigators' studies show Malaysian MSM often do not get HIV tested or initiate PrEP. Mixed methods suggest MSM want these services but prefer a streamlined system to access them that reduces interaction with clinicians where disclosure and perceived judgment occurs. mHealth may overcome these barriers by facilitating prevention services delivery and health decision-making in a confidential, less-stigmatizing, and convenient manner. Overall smartphone growth in Malaysia (63% in 2015 to 89% in 2017), and the investigators' parallel work with MSM indicates that nearly all (>97%) MSM own a smartphone. Findings from qualitative interviews with MSM further indicate preferences for interfacing with 'apps' rather than health professionals as well as local stakeholders indicating strong interest in using such platform to deliver HIV prevention services align with developing culturally tailored mHealth strategies and to engage MSM in virtual communication with providers – all embedded within one app. To the investigators' knowledge however, no mHealth intervention has been developed to improve access to HIV prevention services in Malaysia. The investigators, therefore, propose to pilot test their new clinic-affiliated app (JomPrEP) to promote HIV testing and PrEP uptake in Malaysian MSM. They will conduct a pilot RCT to evaluate the feasibility and acceptability of the JomPrEP app and examine its preliminary efficacy in improving PrEP cascade compared with the control group. The investigators will enroll 90 participants who will be randomized (1:1) to receive either the JomPrEP app or the control group and assessed at 3- and 6-months. Randomization will be stratified by ATS use (16% to 24%) and age. They will conduct exit interviews with participants and clinical staff to examine the barriers and facilitators to the app and obtain feedback to further optimize the app.

Facilities

Sequence: 200580916
Name Centre of Excellence For Research in AIDS (CERiA)
City Kuala Lumpur
Country Malaysia

Conditions

Sequence: 52319165
Name HIV Prevention Program
Downcase Name hiv prevention program

Id Information

Sequence: 40264391
Id Source org_study_id
Id Value K01DA051346
Id Type U.S. NIH Grant/Contract
Id Link https://reporter.nih.gov/quickSearch/K01DA051346

Countries

Sequence: 42683598
Name Malaysia
Removed False

Design Groups

Sequence: 55757947 Sequence: 55757948
Group Type Experimental Group Type Active Comparator
Title JomPrEP App Group Title Control Group
Description Participants in the JomPrEP group will be provided with full app access and will be encouraged to use all features of the app. Description Participants in the control group will receive the JomPrEP app with major intervention features inactivated.

Interventions

Sequence: 52630137 Sequence: 52630138
Intervention Type Other Intervention Type Other
Name Full access to JomPrEP app Name inactivated JomPrEP app
Description All participants will receive the JomPrEP app with access to all of its features which include: customizable page (using avatars and pseudonyms); visual dashboard (track and visualize progress); HIV testing plan (create plan for HIV testing, order self-testing kits, testing site locator); PrEP Care Plan (PrEPxpress, automated reminders for follow-up care, labs, delivery); chat function and discussion forum; tailored messages and reminders; assessment center (weekly assessment on adherence to PrEP, HIV risk, mood); knowledge center (resources on HIV testing and PrEP); Mental health support (screen for P/SUD, counseling feedback, referral to support services); Integration of provider locator (provides users with a GPS enabled map for PrEP and mental health support providers in Malaysia) and Gamification (offers extrinsic motivation by rewarding points/milestones for doing activities within the app). Participants can also contact the RA using the chat function for support. Description Only information and resources for PrEP services will be available along with access to risk assessment tools.

Keywords

Sequence: 80073083 Sequence: 80073084 Sequence: 80073085
Name mobile application Name PrEP Name mHealth
Downcase Name mobile application Downcase Name prep Downcase Name mhealth

Design Outcomes

Sequence: 177925652 Sequence: 177925653 Sequence: 177925654 Sequence: 177925655 Sequence: 177925656 Sequence: 177925657 Sequence: 177925658 Sequence: 177925659 Sequence: 177925660 Sequence: 177925661 Sequence: 177925662 Sequence: 177925663 Sequence: 177925664 Sequence: 177925665 Sequence: 177925666
Outcome Type primary Outcome Type primary Outcome Type primary Outcome Type primary Outcome Type primary Outcome Type primary Outcome Type primary Outcome Type primary Outcome Type primary Outcome Type primary Outcome Type secondary Outcome Type secondary Outcome Type secondary Outcome Type secondary Outcome Type secondary
Measure Feasibility of the JomPrEP app using percentages of individuals screened Measure Feasibility of the JomPrEP app using percentages of individuals eligible Measure Feasibility of the JomPrEP app using percentages of individuals enrolled Measure Feasibility of the JomPrEP app using percentages of individuals retained Measure Feasibility of the JomPrEP app using the percentage of participants that accessed the app Measure Acceptability of the JomPrEP app based on the subjective usability measure Measure Acceptability of the JomPrEP app based on perceived usefulness of participants assessed in qualitative interviews Measure Acceptability of the JomPrEP app based on barriers and facilitators identifies by participants in qualitative interviews Measure Acceptability of the JomPrEP app based on usability concerns identified by participants in qualitative interviews Measure Acceptability of the JomPrEP app based on refinement feedback identified by participants in qualitative data interviews Measure Preliminary Efficacy of the JomPrEP app through dried blood spot testing as PrEP adherence measure Measure Preliminary Efficacy of the JomPrEP app through dried blood spot testing as PrEP adherence measure Measure Preliminary Efficacy of the JomPrEP app using the visual analog scale (VAS) to measure PrEP adherence Measure Preliminary Efficacy of the JomPrEP app using the visual analog scale (VAS) to measure PrEP adherence Measure Preliminary Efficacy of the JomPrEP app using proportion of participants who persist on PrEP
Time Frame 6 months Time Frame 6 months Time Frame 6 months Time Frame 6 months Time Frame 6 months Time Frame 6 months Time Frame 6 months Time Frame 6 months Time Frame 6 months Time Frame 6 months Time Frame 3 months Time Frame 6 months Time Frame 3 months Time Frame 6 months Time Frame 6 months
Description The investigators will use the percentage of individuals screened to determine the feasibility of the JomPrEP app Description The investigators will use the percentage of individuals eligible to determine the feasibility of the JomPrEP app Description The investigators will use the percentage of individuals enrolled to determine the feasibility of the JomPrEP app Description The investigators will use the percentage of individuals retained to determine the feasibility of the JomPrEP app Description The investigators will determine the percentage of participants that accessed the app, with ≥60% of participants accessing app as lower threshold. The higher the percentage, the higher the feasibility. Description Acceptability will be based on descriptive statistics from the subjective usability measure, with a target mean score of ≥ 50. The higher the score, the higher the acceptability. Minimum score for the scale is 0, highest is 100. Description Acceptability will be based on analysis of qualitative data which includes specific areas of perceived usefulness of the app. Description Acceptability will be based on analysis of qualitative data which includes barriers and facilitators. Description Acceptability will be based on analysis of qualitative data which includes usability concerns. Description Acceptability will be based on analysis of qualitative data which includes refinement needed to maximize future implementation. Description The investigators will measure PrEP adherence (using dried blood spots) at 3 months. DBS will quantify tenofovir-diphosphate (TFV-DP) and emtricitabine-triphosphate (FTC-TP) in RBC. Description The investigators will measure PrEP adherence (using dried blood spots) at 6 months. DBS will quantify tenofovir-diphosphate (TFV-DP) and emtricitabine-triphosphate (FTC-TP) in RBC Description The investigators will measure PrEP adherence using the visual analogue scale at 3 months. Description The investigators will measure PrEP adherence using the visual analogue scale at 6 months. Description Preliminary Efficacy of the app will be calculated using the proportion of participants who persist on PrEP. Persistence on PrEP is measured on the app when completing PrEP care.

Sponsors

Sequence: 48457887 Sequence: 48457888 Sequence: 48457889
Agency Class OTHER Agency Class OTHER Agency Class OTHER
Lead Or Collaborator lead Lead Or Collaborator collaborator Lead Or Collaborator collaborator
Name University of Connecticut Name University of Malaya Name Yale University

Overall Officials

Sequence: 29364154
Role Principal Investigator
Name Roman Shrestha, PhD
Affiliation University of Connecticut

Central Contacts

Sequence: 12045633 Sequence: 12045634
Contact Type primary Contact Type backup
Name Roman Shrestha, PhD Name Antoine Khati, MD
Phone +1(903)407-0387
Email roman.shrestha@uconn.edu Email antoine.khati@uconn.edu
Role Contact Role Contact

Design Group Interventions

Sequence: 68348449 Sequence: 68348450
Design Group Id 55757947 Design Group Id 55757948
Intervention Id 52630137 Intervention Id 52630138

Eligibilities

Sequence: 30851083
Gender Male
Minimum Age 18 Years
Maximum Age N/A
Healthy Volunteers Accepts Healthy Volunteers
Criteria Inclusion Criteria: MSM HIV-negative MSM Age more than or equal to 18 Cis-gender men Condomless sex in the last 30 days Own a smartphone Exclusion Criteria: Unable to provide informed consent Unable to read and understand English or Bahasa Malaysia
Gender Description Cis-gender men
Gender Based True
Adult True
Child False
Older Adult True

Calculated Values

Sequence: 254267174
Number Of Facilities 1
Registered In Calendar Year 2021
Were Results Reported False
Has Us Facility False
Has Single Facility True
Minimum Age Num 18
Minimum Age Unit Years
Number Of Primary Outcomes To Measure 10
Number Of Secondary Outcomes To Measure 5

Designs

Sequence: 30596941
Allocation Randomized
Intervention Model Parallel Assignment
Observational Model
Primary Purpose Prevention
Time Perspective
Masking None (Open Label)

Links

Sequence: 4399606 Sequence: 4399607 Sequence: 4399608
Url https://uxpajournal.org/determining-what-individual-sus-scores-mean-adding-an-adjective-rating-scale/ Url https://us.sagepub.com/en-us/nam/transforming-qualitative-information/book7714 Url https://dokumen.pub/the-handbook-of-data-analysis-7-1nbsped-1848601166-978-1-84860-116-1.html
Description Determining What Individual SUS Scores Mean: Adding an Adjective Rating Scale by Aaron Bangor, PhD, CHFP, Philip Kortum, PhD, James Miller, PhD Description Transforming Qualitative Information Thematic Analysis and Code Development. By Richard E. Boyatzis Description Handbook of data analysis. By Roberto P. Franzosi.

Responsible Parties

Sequence: 28963421
Responsible Party Type Principal Investigator
Name Roman Shrestha
Title Assistant Professor
Affiliation University of Connecticut

Study References

Sequence: 52223551 Sequence: 52223552 Sequence: 52223553 Sequence: 52223554 Sequence: 52223555 Sequence: 52223556 Sequence: 52223557 Sequence: 52223558
Pmid 19532070 Pmid 16204405 Pmid 25973907 Pmid 15116282 Pmid 25065857 Pmid 22935078 Pmid 27572401 Pmid 26829517
Reference Type background Reference Type background Reference Type background Reference Type background Reference Type background Reference Type background Reference Type background Reference Type background
Citation Van Tieu H, Koblin BA. HIV, alcohol, and noninjection drug use. Curr Opin HIV AIDS. 2009 Jul;4(4):314-8. doi: 10.1097/COH.0b013e32832aa902. Citation Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005 Nov;15(9):1277-88. doi: 10.1177/1049732305276687. Citation Guadamuz TE, Cheung DH, Wei C, Koe S, Lim SH. Young, Online and in the Dark: Scaling Up HIV Testing among MSM in ASEAN. PLoS One. 2015 May 14;10(5):e0126658. doi: 10.1371/journal.pone.0126658. eCollection 2015. Citation Giordano TP, Guzman D, Clark R, Charlebois ED, Bangsberg DR. Measuring adherence to antiretroviral therapy in a diverse population using a visual analogue scale. HIV Clin Trials. 2004 Mar-Apr;5(2):74-9. doi: 10.1310/JFXH-G3X2-EYM6-D6UG. Citation Grant RM, Anderson PL, McMahan V, Liu A, Amico KR, Mehrotra M, Hosek S, Mosquera C, Casapia M, Montoya O, Buchbinder S, Veloso VG, Mayer K, Chariyalertsak S, Bekker LG, Kallas EG, Schechter M, Guanira J, Bushman L, Burns DN, Rooney JF, Glidden DV; iPrEx study team. Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. Lancet Infect Dis. 2014 Sep;14(9):820-9. doi: 10.1016/S1473-3099(14)70847-3. Epub 2014 Jul 22. Citation Castillo-Mancilla JR, Zheng JH, Rower JE, Meditz A, Gardner EM, Predhomme J, Fernandez C, Langness J, Kiser JJ, Bushman LR, Anderson PL. Tenofovir, emtricitabine, and tenofovir diphosphate in dried blood spots for determining recent and cumulative drug exposure. AIDS Res Hum Retroviruses. 2013 Feb;29(2):384-90. doi: 10.1089/AID.2012.0089. Epub 2012 Oct 10. Citation Castillo-Mancilla J, Seifert S, Campbell K, Coleman S, McAllister K, Zheng JH, Gardner EM, Liu A, Glidden DV, Grant R, Hosek S, Wilson CM, Bushman LR, MaWhinney S, Anderson PL. Emtricitabine-Triphosphate in Dried Blood Spots as a Marker of Recent Dosing. Antimicrob Agents Chemother. 2016 Oct 21;60(11):6692-6697. doi: 10.1128/AAC.01017-16. Print 2016 Nov. Citation Zheng JH, Rower C, McAllister K, Castillo-Mancilla J, Klein B, Meditz A, Guida LA, Kiser JJ, Bushman LR, Anderson PL. Application of an intracellular assay for determination of tenofovir-diphosphate and emtricitabine-triphosphate from erythrocytes using dried blood spots. J Pharm Biomed Anal. 2016 Apr 15;122:16-20. doi: 10.1016/j.jpba.2016.01.038. Epub 2016 Jan 21.