Pre-Exposure Prophylaxis Adherence and HIV Self-Testing App Among Women in the South Bronx: 12-Month Usability, Acceptability, and Feasibility Study
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Abstract Background HIV pre-exposure prophylaxis (PrEP) is underused by cis- and transgender women despite a significant HIV burden. Smartphone technologies are promising tools to support HIV prevention but have yet to be assessed in women. Objective We conducted a 12-month feasibility study to assess the use and acceptability of a mobile phone app, SmartPrEP, designed to support PrEP adherence and HIV self- and partner-testing among women living in an area of elevated HIV burden in New York City. Methods Nonpregnant adult cisgender and transgender women who met US PrEP eligibility criteria and were PrEP naïve, reported PrEP use for 4 HIV risk behaviors in the past 6 months, with 58% (23/40) reporting anal or vaginal sex with more than 1 partner. Over the course of the study, although 8 participants withdrew early, and 14 were lost to follow-up, there were 2 pregnancies and 1 HIV seroconversion. PrEP adherence was low, with 80% (32/40) recording 3 doses per week compared to 20% (8/40). In total, 4 participants conducted HIV self- or partner-testing using SmartPrEP during study follow-up. App acceptability assessed at month 12 was moderate to high (median score 3.71 of max 5, IQR 3.47‐4.16). Conclusions Despite consistently rating the app as acceptable and receiving quarterly HIV testing and counseling, most participants did not achieve optimal PrEP adherence, demonstrating the limitations of this mobile health app among women at elevated risk of HIV. Active navigation and str
Abstract
Abstract Background HIV pre-exposure prophylaxis (PrEP) is underused by cis- and transgender women despite a significant HIV burden. Smartphone technologies are promising tools to support HIV prevention but have yet to be assessed in women. Objective We conducted a 12-month feasibility study to assess the use and acceptability of a mobile phone app, SmartPrEP, designed to support PrEP adherence and HIV self- and partner-testing among women living in an area of elevated HIV burden in New York City. Methods Nonpregnant adult cisgender and transgender women who met US PrEP eligibility criteria and were PrEP naïve, reported PrEP use for 4 HIV risk behaviors in the past 6 months, with 58% (23/40) reporting anal or vaginal sex with more than 1 partner. Over the course of the study, although 8 participants withdrew early, and 14 were lost to follow-up, there were 2 pregnancies and 1 HIV seroconversion. PrEP adherence was low, with 80% (32/40) recording 3 doses per week compared to 20% (8/40). In total, 4 participants conducted HIV self- or partner-testing using SmartPrEP during study follow-up. App acceptability assessed at month 12 was moderate to high (median score 3.71 of max 5, IQR 3.47‐4.16). Conclusions Despite consistently rating the app as acceptable and receiving quarterly HIV testing and counseling, most participants did not achieve optimal PrEP adherence, demonstrating the limitations of this mobile health app among women at elevated risk of HIV. Active navigation and strategies to address gaps in risk perception among women will remain critical, as new, long-acting formulations of PrEP become available.