A Mobile Intervention to Improve Uptake of Pre-Exposure Prophylaxis (PrEP) for Southern Black MSM: A Protocol for Intervention Development and Randomized Controlled Trial (Preprint)
Authors: Whiteley Laura , Rouffiac Anne-Emilie , Brown Larry , Mena Leandro , Craker Lacey , Healy Meredith , Haubrick Kayla 
Published: August 2019

BACKGROUND

The uptake of Pre-Exposure Prophylaxis (PrEP) has been slow for young Black men who have sex with men (BMSM) living in the Southern United States. This is a significant issue because eight of the ten states with the highest rates of new HIV infections are located in the South. Jackson, MS (the site of this proposed project) has the second highest AIDS diagnosis rate in the nation, and the highest rate of HIV infection for young urban Black men who have sex with men. This study will develop and test an engaging, interactive, and cost- effective mobile messaging intervention to improve engagement in PrEP care for BMSM (18-35 yrs) living in Jackson, MS.

OBJECTIVE

The goals of this project are 1) to conduct qualitative interviews with young BMSM in Jackson, MS, to understand individual, community, and structural barriers affecting engagement in PrEP-related care, 2) to assemble a PrEP Mobile Messaging Intervention that includes text messages with publicly available internet content (websites and YouTube videos) that provide factual information, motivational materials, and behavioral skills related to PrEP and HIV prevention, and 3) to evaluate the preliminary efficacy of a text messaging intervention composed of publicly available internet content in a randomized controlled study with PrEP eligible BMSM receiving care in STI/HIV testing clinics located in Jackson, MS.

METHODS

This research protocol will be conducted in 2 phases: a development phase involving in-depth interviews (n = 30) with PrEP eligible BMSM who receive care in STI/HIV testing clinics in MS. These interviews will allow researchers to select the texted material that will be sent out during the intervention. The second phase will consist of a small randomized controlled trial among 66 new participants to examine the preliminary efficacy of the intervention (compared to enhanced standard of care) on attendance at a PrEP Services Appointment (the first step in initiating PrEP care) and receipt of a PrEP prescription. The publicly available material will be sent to PrEP eligible BMSM in 8- 16 interactive text messages over 4 weeks. Study assessments will occur at enrollment and at 4- and 16-weeks post-enrollment.

RESULTS

IRB approval was received on January 16, 2017. Research activities began in February 2018 and are still ongoing.

CONCLUSIONS

This PrEP Mobile Messaging Intervention aims to increase uptake of PrEP by BMSM in the Southern United States. This intervention uses interactive, tailored text messaging and appealing free web content (publicly accessible educational websites and YouTube videos) to promote linkage to PrEP care and increase HIV preventative behaviors. A cost-effective digital PrEP Mobile messaging intervention has great potential to improve information about PrEP, improve motivation to use PrEP, and decrease stigma and structural barriers that often prevent engagement in PrEP-related medical care.

CLINICALTRIAL

Trial Registration: NCT03308097
International Registered Report Identifier (IRRID): NCT03308097