Developing Sustainable and Impactful Mobile Phone HIV Testing Interventions for Spanish-Speaking Men Who Have Sex With Men in the United States: Lessons Learned From Informative Interviews

Abstract

BackgroundAlthough many men who have sex with men (MSM) test for HIV at least once in their lifetime, opportunities to improve regular HIV testing, particularly among Hispanic or Latino MSM, is needed. Many mHealth interventions in development, including the ones on HIV testing, have primarily focused on English-speaking white, black, and MSM of other races. To date, no studies have assessed app use, attitudes, and motivations for downloading and sustaining use of mobile apps and preferences with respect to HIV prevention among Spanish-speaking, Hispanic MSM in the United States.ObjectiveThe primary aims of this study were to determine what features and functions of smartphone apps do Hispanic, Spanish-speaking MSM believe are associated with downloading apps to their smartphones, (2) what features and functions of smartphone apps are most likely to influence men’s sustained use of apps over time, and (3) what features and functions do men prefer in a smartphone app aimed to promote regular testing for HIV.MethodsInterviews (N=15) were conducted with a racially diverse group of sexually active, HIV-negative, Spanish-speaking, Hispanic MSM in Miami, Florida. Interviews were digitally recorded, transcribed verbatim, translated back to English, and de-identified for analysis. A constant-comparison method (ie, grounded theory coding) was employed to examine themes that emerged from the interviews.ResultsPersonal interest was the primary reason associated with whether men downloaded an app. Keeping personal information secure, cost, influence by peers and posted reviews, ease of use, and functionality affected whether they downloaded and used the app over time. Men also reported that entertainment value and frequency of updates influenced whether they kept and continued to use an app over time. There were 4 reasons why participants chose to delete an app—dislike, lack of use, cost, and lack of memory or space. Participants also shared their preferences for an app to encourage regular HIV testing by providing feedback on test reminders, tailored testing interval recommendations, HIV test locator, and monitoring of personal sexual behaviors.ConclusionsThe features and functions of mobile apps that Spanish-speaking MSM in this study believed were associated with downloading and/or sustained engagement of an app generally reflected the priorities mentioned in an earlier study with English-speaking MSM. Unlike the earlier study, Spanish-speaking MSM prioritized personal interest in a mobile app and de-emphasized the efficiency of an app to make their lives easier in their decision to download an app to their mobile device. Tailoring mobile apps to the language and needs of Spanish-speaking MSM is critical to help increase their willingness to download a mobile app. Despite the growing number of HIV-prevention apps in development, few are tailored to Spanish-speaking MSM, representing an important gap that should be addressed in future research.

Assessing the Prevalence and Determinants of Exposure-Influenced HIV Testing among a Sample of Pre- and Post-Exposure Prophylaxis-Naïve Young Men Who Have Sex with Men in the United States

“…This finding was consistent with a nationally representative YMSM study—88.2% tested in their lifetime, 67.4% tested in the past 12 months, and 63.4% tested in the past 6 months, respectively) [ 16 ]. In the meantime, our results were in line with findings from numerous studies showing a decreasing HIV testing prevalence from lifetime to more recent time windows (e.g., past 3–6 months), highlighting the need for continuous efforts to strengthen recent and frequent HIV testing among YMSM in the US [ 7 , 15 , 16 , 32 , 33 ].…”

A systematic evaluation of mobile apps to improve the uptake of and adherence to HIV pre-exposure prophylaxis

“…Compared with other sexual health apps, PrEP apps were unique in that they provided the ability for users to self-assess their indications for PrEP to evaluate their HIV risk and suitability for the prevention modality. Also, providing highquality information and functionality is important concerning the acceptability of sexual health apps, 36,37 and the PrEP apps in this study performed well with respect to both of these aspects and could guide future sexual health apps in this regard. Research on sexual health apps has acknowledged the importance of integrating healthcare provider locators 38,39 and reminders for medications, appointments and laboratory results, 39 both of which were features found within several of the PrEP apps.…”

“…37,40 The PrEP-related apps did not score well in terms of engagement, thus apps for improving PrEP utilisation may benefit from incorporating additional gaming and entertainment features. PrEP-related apps could also benefit from including more features that allow for app user communication with healthcare providers or educators, 36,39 tracking of key personal sexual behaviours 37,41 and locating other types of sexual healthcare services, such as HIV testing. 36,37 Limitations Despite the novelty of this study and its promising findings, there are limitations that should be addressed.…”

“…PrEP-related apps could also benefit from including more features that allow for app user communication with healthcare providers or educators, 36,39 tracking of key personal sexual behaviours 37,41 and locating other types of sexual healthcare services, such as HIV testing. 36,37 Limitations Despite the novelty of this study and its promising findings, there are limitations that should be addressed. First, the terms used in the search strategy may not have been exhaustive of pertinent terms to use for finding PrEP-related apps, thus some relevant apps may have been missed.…”

Adapting an m-Health Intervention for Spanish-Speaking Latinx People Living with HIV in the Nonurban Southern United States

“…19 However, preferences of Spanish-speaking Latinx PLWH may differ from those of English-speaking PLWH with whom the app was originally developed, and tailoring existing m-health interventions to Latinx PLWH has been identified as a need in the literature. 20 Culturally tailored health care requires input from patients 21 ; therefore, we conducted formative study to guide adaptation of PL for Spanish-speaking Latinx PLWH.…”