the development of a mobile-based app to increase uptake of pre-exposure prophylaxis (prep) by men who have sex with men in china

Conditions: HIV; Pre-exposure Prophylaxis

Summary: this study aims to use a mini-application on the popular chinese social media mobile platform, wechat, to improve hiv pre-exposure prophylaxis (prep) uptake among at-risk men who have sex with men (msm). unc investigators will work in close partnership with a well-established hiv special hospital and the local msm community to understand key barriers to prep use, and develop a mobile-based intervention to increase prep uptake among young msm in guangzhou, china.

this study includes two parts. before the start of part 1, a mini-app prototype for promoting hiv pre-exposure prophylaxis (prep) uptake will have been developed from a prior msm community-driven hackathon contest. prep is an antiretroviral medicines-based prevention strategy against hiv infection, which has been proved save and effective. part 1 includes in-depth interviews with 40 hiv-negative young msm (18 and above) with a brief survey to collect demographic data. the interview topics include prep-related perceptions and feedback on the design of a mini-app prototype. findings from part 1 will inform refining the mini-app before the start of part 2. in part 2, a small two-arm randomized control trial with 70 young msm (18 and above) will be conducted to evaluate the preliminary efficacy of the mini-app in improving prep-related perceptions and actual prep uptake, compared to a control group of standard of care. participants in part 2 will be followed up for 12 weeks (8 week intervention and after-intervention follow-up at 12th week). a subgroup of participants (n=15) from both the intervention arm and the control arm will receive two rounds of in-depth interviews, separately at the 4th and 8th week, to share their experience of using the app and changed perceptions and/or behaviors related to prep.

Eligibility criteria:
inclusion criteria: * part 1: hiv-negative men who have sex with men (msm): must self-report: being assigned male sex at birth, hiv-negative, age 18 and above, ever having had anal sex with another man, identify as a chinese citizen, own a smartphone, able to being willing to sign written informed consent and participate in the study as procedures required. part 2: hiv-negative men who have sex with men (msm): same characteristics as in part 1. and, they must report : * having a smartphone with wechat installed. * being assigned male sex at birth, hiv-negative, age 18 and above, ever having had anal sex with another man, currently reside in guangzhou, china, identifying as a chinese citizen, able to sign written informed consent and participate in the study as procedures require. and * at least one criterion associated with high risk of hiv infection in the past 6 months prior to enrollment as follows: * unprotected (condomless) anal intercourse with male partner(s) * more than two male partners (regardless of condom use and hiv serostatus) * reported sti, such as syphilis, herpes simplex virus-2 (hsv-2), gonorrhea, chlamydia, chancroid, or lymphogranuloma venereum. * reported use of post-exposure prophylaxis (pep) * have a sexual partner living with hiv exclusion criteria: * part 1: individuals who report any following status will be excluded from participating part 1: * hiv-positive * mental health issues which may compromise participant adherence or safety, including memory loss, cognitive impairment, intellectual disability, or communication disorders. * part 2: * hiv-positive (self-report or lab-confirmed) * currently taking oral prep based on self-report * symptoms of acute hiv infection within the prior 30 days * contradictions to taking oral prep * personal diagnosis or family history of hemophilia * chronic hepatitis b (self-report) * participating in another research study related to hiv and antiretroviral therapy or other intervention study * having serious chronic disease, including metabolic diseases (such as diabetes), neurological, and psychiatric disorders * mental health issues which may compromise participant adherence or safety, including memory loss, cognitive impairment, intellectual disability, or communication disorders

Keywords: hiv prep