Acceptability of a digital patient notification and linkage-to-care tool for French PrEPers (WeFLASH^©): Key stakeholders' perspectives

Abstract

The objective of this study was to describe stakeholders’ perspectives on the acceptability of WeFLASH© (AADISS, Paris, France), a digital smartphone sexually transmitted infection (STI) patient notification (PN) tool to be launched among French HIV pre-exposure prophylaxis users (PrEPers). In Paris, Lyon, and Nice, we conducted 2-hour focus group discussions with PrEPers (n = 21) and community mediators (n = 10), and one-on-one interviews with PrEP-prescribing physicians (n = 5) and HIV/STI management decision-makers (n = 4). Recordings were transcribed. The analysis focused on perceived benefits and risks. Concerning benefits, participants mentioned that WeFLASH© could provide: improved PN and STI screening, by refining the notification of anonymous partners; customized linkage-to-care, by providing users with tailored information on care; and transferable epidemiological data, by filling a need for real-time data. Participants anticipated risks for: privacy and confidentiality and suggested specific security settings to protect users’ identity; sexual behavior and suggested game-like functions to improve the integration of the tool in sexual contexts; and fairness and emphasized the importance of making WeFLASH© accessible to all men who have sex with men. WeFLASH© could facilitate PN for an increasing proportion of anonymous partners met online, and empower users, including notified partners, on questions of confidentiality and consent, access to STI prevention and screening services, and access to data.

Understanding the Risks and Benefits of a Patient Portal Configured for HIV Care: Patient and Healthcare Professional Perspectives

“…Security and privacy are common concerns with patient portals and are considered a major barrier to their uptake [40][41][42][43][44]. However, past research has found patients to be willing to accept confidentiality risks if they find some benefits like the convenience of online access to their personal health information [45] or to use an effective and useful mobile application [46]. Additionally, as suggested by this study's findings, measures can be applied to maximize security, including an automated logout after a certain time of inactivity and a two-step authentication process to log in and verify users' identity.…”

Digital interventions for STI and HIV partner notification: a scoping review

“…So it is more difficult to notify. 37 Another qualitative study noted similar benefits in their findings: Being anonymous might encourage the guy [partner] to reveal it [his HIV/ STI diagnosis]. 35 In contrast, hypothetical acceptability of appbased PN found that while 74% of 791 MSM participants were comfortable using anonymous PN, only 24% reported preference for using this method.…”

“…Nineteen of 26 studies were quantitative, [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] including one randomised controlled trial (RCT), 21 four were qualitative [34][35][36][37] and three were mixed methods studies. [38][39][40] Most explored established interventions (13/26), 16 21-26 28-30 32 38 39 nine explored hypothetical interventions, 15-19 35-37 40 five explored a mixture of implemented PN and hypothetical interventions, 20 27 31 33 34 detailed in tables 1-3 and online supplemental appendix C. The majority explored digital PN methods designed for use by the index patient (21/26).…”

Improving digital partner notification for sexually transmitted infections and HIV through a systematic review and application of the Behaviour Change Wheel approach

“…A summary of the article characteristics is in Table 2. Populations addressed included HIV pre-exposure prophylaxis (PrEP) users, 21 cisgender men and transwomen, 22 men who have sex with men (MSM), 17,23,24 people recently diagnosed with chlamydia 9,25 and the general population. 26 The eight articles used a range of qualitative and quantitative approaches.…”

“…26 The eight articles used a range of qualitative and quantitative approaches. Five studies related to hypothetical digital PN interventions; 17,[21][22][23]26 only one reported solely on an intervention that had been delivered 25 and two concerned both real and hypothetical interventions. 9,24…”