An instant messaging mobile phone application for promoting HIV pre-exposure prophylaxis uptake among Chinese gay, bisexual and other men who have sex with men: A mixed methods feasibility and piloting randomized controlled trial study

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  • Li C.
    • Affiliation: Gillings School of Global Public Health, Department of Health Behavior
  • Xiong Y.
    • Affiliation: School of Medicine, UNC Project-China
  • Maman S.
    • Affiliation: Gillings School of Global Public Health, Department of Health Behavior
  • Matthews D.D.
    • Affiliation: Gillings School of Global Public Health, Department of Health Behavior
  • Fisher E.B.
    • Affiliation: Gillings School of Global Public Health, Department of Health Behavior
  • Tang W.
    • Affiliation: School of Medicine, UNC Project-China
  • Huang H.
    • Other Affiliation: Wuhan Tongxing LGBTQ Center
  • Mu T.
    • Other Affiliation: Qingdao Eighth People’s Hospital
  • Tong X.
    • Other Affiliation: Xi’an Polytechnic University
  • Yu J.
    • Other Affiliation: Beijing Naomi Media Company
  • Yang Z.
    • Affiliation: School of Medicine, UNC Project-China
  • Sherer R.
    • Other Affiliation: University of Chicago
  • Hazra A.
    • Other Affiliation: University of Chicago
  • Lio J.
    • Other Affiliation: University of Chicago
  • Li L.
    • Other Affiliation: Guangzhou Number Eight People’s Hospital
  • Tucker J.D.
    • Affiliation: School of Medicine, UNC Project-China
  • Muessig K.E.
    • Affiliation: Gillings School of Global Public Health, Department of Health Behavior
Abstract
  • Background Mobile health (mHealth) is a promising intervention mode for HIV prevention, but little is known about its feasibility and effects in promoting pre-exposure prophylaxis (PrEP) uptake among Chinese gay, bisexual and other men who have sex with men (GBMSM). Methods We evaluated an instant messaging application using a WeChat-based mini-app to promote PrEP uptake among GBMSM via a mixed-methods design that includes a 12-week, two-arm randomized controlled pilot trial and in-depth progress interviews in Guangzhou, China. Primary outcomes include the number of PrEP initiations, individual-level psychosocial variables related to PrEP initiation, and usability of the PrEP mini-app. Results Between November 2020 and April 2021, 70 GBMSM were successfully enrolled and randomized into two arms at 2:1 ratio (46 to the intervention arm, 24 to the control arm). By the end of 12-week follow-up, 22 (31.4%) participants completed the initial consultation and lab tests for PrEP, and 13 (18.6%) filled their initial PrEP prescription. We observed modest but non-significant improvements in participants’ intention to use PrEP, actual PrEP initiation, PrEP-related self-efficacy, stigma, and attitudes over 12 weeks when comparing the mini-app and the control arms. Qualitative interviews revealed the key barriers to PrEP uptake include anticipated stigma and discrimination in clinical settings, burden of PrEP care, and limited operating hours of the PrEP clinic. In-person clinic navigation support was highly valued. Conclusions This pilot trial of a mobile phone-based PrEP mini-app demonstrated feasibility and identified limitations in facilitating PrEP uptake among Chinese GBMSM. Future improvements may include diversifying the content presentation in engaging media formats, adding user engagement features, and providing off-line in-clinic navigation support during initial PrEP visit. More efforts are needed to understand optimal strategies to identify and implement alternative PrEP provision models especially in highly stigmatized settings with diverse needs. Trial registration Trial registration: The study was prospectively registered on clinicaltrials.gov (NCT04426656) on 11 June, 2020.
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  • Article
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  • Attribution 4.0 International
Journal title
  • PLoS ONE
Journal volume
  • 18
Journal issue
  • 11-Nov
Language
  • English
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  • Publisher
ISSN
  • 1932-6203
Publisher
  • Public Library of Science

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