IPROC iproc Iproceedings 2369-6893 JMIR Publications Toronto, Canada v8i1e39358 10.2196/39358 Abstract Abstract Adaptation of a Theory-Based, Clinic-Affiliated Smartphone App to Improve HIV Testing and Pre-exposure Prophylaxis Uptake Among Gay, Bisexual, and Other Men Who Have Sex With Men in Malaysia Pagoto Sherry Rosen Aviana O BA, MS 1 https://orcid.org/0000-0002-3533-5682 Wickersham Jeffrey A PhD 2 Altice Frederick L MD 2 Khati Antoine MD 1 Luces Jeffrey Ralph BA 3 Ni Zhao PhD 2 Zhou Xin PhD 2 Azwa Iskandar MBChB, MRCP, DIP GUM, DIP HIV 4 Kamarulzaman Adeeba MBBS, FRACP, FASc 4 Ab Halim Mohd Akbar BA 4 Shrestha Roman MPH, PhD 1
Department of Allied Health Sciences University of Connecticut Koons Hall 358 Mansfield Road U-1101 Storrs, CT, 06269-1101 United States 1 860 486 2446 roman.shrestha@uconn.edu
Department of Allied Health Sciences University of Connecticut Storrs, CT United States Section of Infectious Diseases Department of Internal Medicine Yale School of Medicine New Haven, CT United States College of Allied Medical Professions University of the Philippines Manila Philippines Centre of Excellence for Research in AIDS Faculty of Medicine University of Malaya Kuala Lumpur Malaysia Corresponding Author: Roman Shrestha roman.shrestha@uconn.edu Jan-Dec 2022 6 7 2022 8 1 e39358 7 5 2022 15 6 2022 ©Aviana O Rosen, Jeffrey A Wickersham, Frederick L Altice, Antoine Khati, Jeffrey Ralph Luces, Zhao Ni, Xin Zhou, Iskandar Azwa, Adeeba Kamarulzaman, Mohd Akbar Ab Halim, Roman Shrestha. Originally published in Iproceedings (https://www.iproc.org), 06.07.2022. 2022

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 Background

In Malaysia, HIV disproportionately affects gay, bisexual, and other men who have sex with men (GBMSM). Homosexuality and substance use are criminalized in Malaysia, making GBMSM bear multilevels of social stigma and discrimination, including in health care. Mobile health (mHealth), particularly smartphone apps, is a promising and cost-effective strategy for reaching stigmatized and hard-to-reach populations like GBMSM and linking them to HIV prevention services (eg, HIV testing and pre-exposure prophylaxis [PrEP]), particularly in the context of COVID-19.

 Objective

This study aimed to adapt the HealthMindr app (Emory University), which was developed with GBMSM in the United States, to improve HIV testing and PrEP uptake for GBMSM in Malaysia.

 Methods

We conducted online focus group discussions (FGDs) between August and September 2021 with 20 GBMSM and 16 community stakeholders (eg, doctors, nurses, pharmacists, and nongovernmental organization staff). Participants were asked questions regarding their preferences for functions and features in mHealth apps among GBMSM and suggestions for adapting the HealthMindr app to the Malaysian context. Each session was digitally recorded and transcribed. Transcripts were inductively coded using Dedoose software (University of California, Los Angeles) and analyzed to identify and interpret emerging themes.

 Results

The FGDs with GBMSM revealed preferences for interfacing with apps to access HIV testing, PrEP, and counseling services. Stakeholders showed strong interest in using the app-based platform to deliver integrated care (eg, HIV and mental health). The key themes mostly focused on adaptation and refinement for the Malaysian context and were related to cultural and stylistic preferences (design and user interface), engagement strategies (reward systems, marketing campaigns, and reminders), and recommendations for new functions (enhanced communication options via chat and discussion forums) in a one-stop hub for all HIV prevention needs (HIV self-testing, PrEP, and postexposure prophylaxis) that minimize privacy and confidentiality risks.

 Conclusions

Our data suggest that a tailored HIV-prevention app would be acceptable for GBMSM in Malaysia. The findings provided detailed recommendations for the successful adaptation and refinement of the existing platform for optimal use in the Malaysian context.

 Conflicts of Interest

None declared.

 HIV HIV prevention pre-exposure prophylaxis PrEP HIV test men who have sex with men MSM mHealth eHealth Malaysia focus groups