Behavioral Efficacy of a Sexual Health Mobile App for Men Who Have Sex With Men: Randomized Controlled Trial of Mobile Messaging for Men

• Type of Material: Article
• Authors: Patrick Sullivan, Emory University; Robert Stephenson, Emory University; Sabina Hirshfield, SUNY Downstate Health Sciences University; Christina Mehta, Emory University; Ryan Zahn, Emory University; Jose A Bauermeister, University of Pennslyvania; Keith Horvath, San Diego State University; Mary Ann Chiasson, Columbia University; Deborah Gelaude, Centers for Disease Control and Prevention, Atlanta; Selby Mullin, Emory University; Martin J Downing Jr, City University of New York; Evelyn Jolene Olansky, Ctr Dis Control & Prevent; Sarah Wiatrek, Emory University; Erin Q Rogers, Emory University; Eli Rosenberg, Emory University; Aaron Siegler, Emory University; Gordon Mansergh, Centers for Disease Control and Prevention, Atlanta
• Language: English
• Date: 2022-02-02
• Publisher: JMIR PUBLICATIONS, INC
• Publication Version: Final Published Version
• Copyright Statement: ©Patrick Sean Sullivan, Rob Stephenson, Sabina Hirshfield, Cyra Christina Mehta, Ryan Zahn, Jose A Bauermeister, Keith Horvath, Mary Ann Chiasson, Deborah Gelaude, Shelby Mullin, Martin J Downing Jr, Evelyn Jolene Olansky, Sarah Wiatrek, Erin Q Rogers, Eli Rosenberg, Aaron J Siegler, Gordon Mansergh
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.2196/34574
• Title of Journal or Parent Work: JOURNAL OF MEDICAL INTERNET RESEARCH
• Volume: 24
• Issue: 2
• Start Page: e34574
• End Page: e34574
• Grant/Funding Information: This study was funded through the US Centers for Disease Control and Prevention (CDC) to Emory University (cooperative agreement no. U01PS004977) and the US National Institutes of Health (P30AI050409).
• Keywords: testing; Health Care Sciences & Services; Medical Informatics; United States; Life Sciences & Biomedicine; app; bisexual; men who have sex with men; efficacy; video; PrEP; Science & Technology; tool; MSM; HIV PREVENTION; HIV; HIV prevention; gay; STI; sexuality; TECHNOLOGY; INTERVENTIONS; mHealth; behavior; prevention; randomized clinical trial
• Research Categories: Health Sciences, Nursing; Biology, Biostatistics; Health Sciences, Epidemiology

Abstract

Background: Gay, bisexual, and other men who have sex with men (GBMSM) face the highest burden of HIV in the United States, and there is a paucity of efficacious mobile health (mHealth) HIV prevention and care interventions tailored specifically for GBMSM. We tested a mobile app combining prevention messages and access to core prevention services for GBMSM. Objective: This study aims to measure the efficacy of the Mobile Messaging for Men (M-cubed) app and related services to increase HIV prevention and care behaviors in diverse US GBMSM. Methods: We conducted a randomized open-label study with a waitlist control group among GBMSM in 3 groups (low-risk HIV-negative group, high-risk HIV-negative group, and living-with-HIV [LWH] group) recruited online and in venues in Atlanta, Detroit, and New York City. Participants were randomly assigned to receive access to the app immediately or at 9 months after randomization. The app provided prevention messages in 6 domains of sexual health and offered ordering of at-home HIV and sexually transmitted infection test kits, receiving preexposure prophylaxis (PrEP) evaluations and navigation, and service locators. Serostatus- and risk-specific prevention outcomes were evaluated at baseline, at the end of the intervention period, and at 3, 6, and 9 months after the intervention period. Results: In total, 1226 GBMSM were enrolled and randomized; of these 611 (49.84%) were assigned to the intervention group and 608 (99.51%) were analyzed, while 615 (50.16%) were assigned to the control group and 612 (99.51%) were analyzed. For high-risk GBMSM, allocation to the intervention arm was associated with higher odds of HIV testing during the intervention period (adjusted odds ratio [aOR] 2.02, 95% CI 1.11-3.66) and with higher odds of using PrEP in the 3 months after the intervention period (aOR 2.41, 95% CI 1.00-5.76, P<.05). No changes in HIV prevention or care were associated with allocation to the intervention arm for the low-risk HIV-negative and LWH groups. Conclusions: Access to the M-cubed app was associated with increased HIV testing and PrEP use among high-risk HIV-negative GBMSM in 3 US cities. The app could be made available through funded HIV prevention providers; additional efforts are needed to understand optimal strategies to implement the app outside of the research setting.