Developing a Mobile App (LYNX) to Support Linkage to HIV/Sexually Transmitted Infection Testing and Pre-Exposure Prophylaxis for Young Men Who Have Sex With Men: Protocol for a Randomized Controlled Trial.

• Type of Material: Article
• Authors: Albert Liu, San Francisco Department of Public Health; Kenneth Coleman, San Francisco Department of Public Health; Kelly Bojan, John H Stroger Jr Hospital; Pedro Alonso Serrano, John H Stroger Jr Hospital; Temitope Oyedele, John H Stroger Jr Hospital; Amayvis Garcia, University of South Florida; Elizabeth Enriquez-Bruce, University of South Florida; Patricia Emmanuel, University of South Florida; Jeb Jones, Emory University; Patrick S Sullivan, Emory University; Lisa Hightow-Weidman, University of North Carolina; Susan Buchbinder, San Francisco Department of Public Health; Hyman Scott, San Francisco Department of Public Health
• Language: English
• Date: 2019-01-25
• Publisher: JMIR Publications
• Publication Version: Final Published Version
• Copyright Statement: ©Albert Liu, Kenneth Coleman, Kelly Bojan, Pedro Alonso Serrano, Temitope Oyedele, Amayvis Garcia, Elizabeth Enriquez-Bruce, Patricia Emmanuel, Jeb Jones, Patrick Sullivan, Lisa Hightow-Weidman, Susan Buchbinder, Hyman Scott. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 25.01.2019.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.2196/10659
• Title of Journal or Parent Work: JMIR Research Protocols
• ISSN: 1929-0748
• Volume: 8
• Issue: 1
• Start Page: e10659
• End Page: e10659
• Keywords: youth; sexually transmitted infections; HIV testing; adolescent; men who have sex with men; pre-exposure prophylaxis; mobile app; sexually transmitted diseases
• Research Categories: Health Sciences, Public Health; Psychology, Social

Abstract

BACKGROUND: Young men who have sex with men (YMSM) in the United States have among the highest incidence of HIV and sexually transmitted infection (STI) and the lowest uptake of HIV and STI testing and pre-exposure prophylaxis (PrEP). Nearly universal mobile phone ownership among youth provides an opportunity to leverage mobile health apps to increase HIV/STI testing and PrEP uptake among YMSM. OBJECTIVE: The goals of this project are to develop and refine LYNX, a novel mobile app to support linkage to HIV/STIs testing and PrEP services among YMSM in the United States, and to evaluate the acceptability and feasibility of LYNX in a pilot randomized controlled trial (RCT). METHODS: This research protocol will be conducted in 3 phases: an iterative development phase with a series of 3 focus groups among 20 YMSM to refine the LYNX app; an open technical pilot among 15 YMSM to optimize usability of the app; and then a 6-month pilot RCT among 60 HIV-uninfected YMSM at risk for HIV acquisition. Developed using the Information, Motivation, and Behavioral skills theoretical model, the LYNX app includes an electronic diary to track sexual behaviors (information), a personalized risk score to promote accurate risk perception (information/motivation), testing reminders (motivation/behavioral skills), and access to home-based HIV/STI testing options and geospatial-based HIV/STI testing care sites (behavioral skills). Feasibility and acceptability will be assessed through app analytics of usage patterns and acceptability scales administered via computer-assisted self-interview at 3 and 6 months. We will also evaluate preliminary efficacy by comparing the proportion of YMSM who test at least once during the 6-month pilot and the proportion who successfully link to a PrEP provider in the intervention versus control groups. RESULTS: Formative work is currently underway. The LYNX pilot RCT will begin enrollment in October 2018, with study results available in 2019. CONCLUSIONS: The LYNX app is one of the first mobile apps designed to increase HIV/STI testing and PrEP uptake among YMSM. As low-perceived risk is a barrier to HIV/STI testing and PrEP use among youth, the personalized risk assessment and interactive sexual diary in LYNX could assist YMSM in better understanding their HIV risk and providing motivation to test for HIV/STIs and initiate PrEP. Coupled with community-based recruitment, this novel mobile app has great potential to reach and engage YMSM not currently involved in care and increase rates of HIV/STI testing and PrEP uptake in this vulnerable population. TRIAL REGISTRATION: ClinicalTrials.gov NCT03177512; https://clinicaltrials.gov/ct2/show/NCT03177512 (Archived by WebCite at http://www.webcitation.org/73c917wAw). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/10659.