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Developing a Mobile App (LYNX) to Support Linkage to HIV/Sexually Transmitted Infection Testing and Pre-Exposure Prophylaxis for Young Men Who Have Sex With Men: Protocol for a Randomized Controlled Trial.
JMIR Res Protoc. 2019 Jan 25; 8(1):e10659.JR

Abstract

BACKGROUND

Young men who have sex with men (YMSM) in the United States have among the highest incidence of HIV and sexually transmitted infection (STI) and the lowest uptake of HIV and STI testing and pre-exposure prophylaxis (PrEP). Nearly universal mobile phone ownership among youth provides an opportunity to leverage mobile health apps to increase HIV/STI testing and PrEP uptake among YMSM.

OBJECTIVE

The goals of this project are to develop and refine LYNX, a novel mobile app to support linkage to HIV/STIs testing and PrEP services among YMSM in the United States, and to evaluate the acceptability and feasibility of LYNX in a pilot randomized controlled trial (RCT).

METHODS

This research protocol will be conducted in 3 phases: an iterative development phase with a series of 3 focus groups among 20 YMSM to refine the LYNX app; an open technical pilot among 15 YMSM to optimize usability of the app; and then a 6-month pilot RCT among 60 HIV-uninfected YMSM at risk for HIV acquisition. Developed using the Information, Motivation, and Behavioral skills theoretical model, the LYNX app includes an electronic diary to track sexual behaviors (information), a personalized risk score to promote accurate risk perception (information/motivation), testing reminders (motivation/behavioral skills), and access to home-based HIV/STI testing options and geospatial-based HIV/STI testing care sites (behavioral skills). Feasibility and acceptability will be assessed through app analytics of usage patterns and acceptability scales administered via computer-assisted self-interview at 3 and 6 months. We will also evaluate preliminary efficacy by comparing the proportion of YMSM who test at least once during the 6-month pilot and the proportion who successfully link to a PrEP provider in the intervention versus control groups.

RESULTS

Formative work is currently underway. The LYNX pilot RCT will begin enrollment in October 2018, with study results available in 2019.

CONCLUSIONS

The LYNX app is one of the first mobile apps designed to increase HIV/STI testing and PrEP uptake among YMSM. As low-perceived risk is a barrier to HIV/STI testing and PrEP use among youth, the personalized risk assessment and interactive sexual diary in LYNX could assist YMSM in better understanding their HIV risk and providing motivation to test for HIV/STIs and initiate PrEP. Coupled with community-based recruitment, this novel mobile app has great potential to reach and engage YMSM not currently involved in care and increase rates of HIV/STI testing and PrEP uptake in this vulnerable population.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03177512; https://clinicaltrials.gov/ct2/show/NCT03177512 (Archived by WebCite at http://www.webcitation.org/73c917wAw).

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/10659.

Authors+Show Affiliations

Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, United States. Department of Medicine, University of California, San Francisco, San Francisco, CA, United States.Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, United States.John H Stroger Jr Hospital, Chicago, IL, United States. The Ruth M Rothstein CORE Center, Chicago, IL, United States.John H Stroger Jr Hospital, Chicago, IL, United States. The Ruth M Rothstein CORE Center, Chicago, IL, United States.John H Stroger Jr Hospital, Chicago, IL, United States. The Ruth M Rothstein CORE Center, Chicago, IL, United States.Department of Pediatrics, University of South Florida, Tampa, Tampa, FL, United States.Department of Pediatrics, University of South Florida, Tampa, Tampa, FL, United States.Department of Pediatrics, University of South Florida, Tampa, Tampa, FL, United States.Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States.Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, United States. Department of Medicine, University of California, San Francisco, San Francisco, CA, United States.Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, United States. Department of Medicine, University of California, San Francisco, San Francisco, CA, United States.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30681964

Citation

Liu, Albert, et al. "Developing a Mobile App (LYNX) to Support Linkage to HIV/Sexually Transmitted Infection Testing and Pre-Exposure Prophylaxis for Young Men Who Have Sex With Men: Protocol for a Randomized Controlled Trial." JMIR Research Protocols, vol. 8, no. 1, 2019, pp. e10659.
Liu A, Coleman K, Bojan K, et al. Developing a Mobile App (LYNX) to Support Linkage to HIV/Sexually Transmitted Infection Testing and Pre-Exposure Prophylaxis for Young Men Who Have Sex With Men: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2019;8(1):e10659.
Liu, A., Coleman, K., Bojan, K., Serrano, P. A., Oyedele, T., Garcia, A., Enriquez-Bruce, E., Emmanuel, P., Jones, J., Sullivan, P., Hightow-Weidman, L., Buchbinder, S., & Scott, H. (2019). Developing a Mobile App (LYNX) to Support Linkage to HIV/Sexually Transmitted Infection Testing and Pre-Exposure Prophylaxis for Young Men Who Have Sex With Men: Protocol for a Randomized Controlled Trial. JMIR Research Protocols, 8(1), e10659. https://doi.org/10.2196/10659
Liu A, et al. Developing a Mobile App (LYNX) to Support Linkage to HIV/Sexually Transmitted Infection Testing and Pre-Exposure Prophylaxis for Young Men Who Have Sex With Men: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2019 Jan 25;8(1):e10659. PubMed PMID: 30681964.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Developing a Mobile App (LYNX) to Support Linkage to HIV/Sexually Transmitted Infection Testing and Pre-Exposure Prophylaxis for Young Men Who Have Sex With Men: Protocol for a Randomized Controlled Trial. AU - Liu,Albert, AU - Coleman,Kenneth, AU - Bojan,Kelly, AU - Serrano,Pedro Alonso, AU - Oyedele,Temitope, AU - Garcia,Amayvis, AU - Enriquez-Bruce,Elizabeth, AU - Emmanuel,Patricia, AU - Jones,Jeb, AU - Sullivan,Patrick, AU - Hightow-Weidman,Lisa, AU - Buchbinder,Susan, AU - Scott,Hyman, Y1 - 2019/01/25/ PY - 2018/03/31/received PY - 2018/09/13/accepted PY - 2018/07/08/revised PY - 2019/1/26/entrez PY - 2019/1/27/pubmed PY - 2019/1/27/medline KW - HIV testing KW - adolescent KW - men who have sex with men KW - mobile app KW - pre-exposure prophylaxis KW - sexually transmitted diseases KW - sexually transmitted infections KW - youth SP - e10659 EP - e10659 JF - JMIR research protocols JO - JMIR Res Protoc VL - 8 IS - 1 N2 - BACKGROUND: Young men who have sex with men (YMSM) in the United States have among the highest incidence of HIV and sexually transmitted infection (STI) and the lowest uptake of HIV and STI testing and pre-exposure prophylaxis (PrEP). Nearly universal mobile phone ownership among youth provides an opportunity to leverage mobile health apps to increase HIV/STI testing and PrEP uptake among YMSM. OBJECTIVE: The goals of this project are to develop and refine LYNX, a novel mobile app to support linkage to HIV/STIs testing and PrEP services among YMSM in the United States, and to evaluate the acceptability and feasibility of LYNX in a pilot randomized controlled trial (RCT). METHODS: This research protocol will be conducted in 3 phases: an iterative development phase with a series of 3 focus groups among 20 YMSM to refine the LYNX app; an open technical pilot among 15 YMSM to optimize usability of the app; and then a 6-month pilot RCT among 60 HIV-uninfected YMSM at risk for HIV acquisition. Developed using the Information, Motivation, and Behavioral skills theoretical model, the LYNX app includes an electronic diary to track sexual behaviors (information), a personalized risk score to promote accurate risk perception (information/motivation), testing reminders (motivation/behavioral skills), and access to home-based HIV/STI testing options and geospatial-based HIV/STI testing care sites (behavioral skills). Feasibility and acceptability will be assessed through app analytics of usage patterns and acceptability scales administered via computer-assisted self-interview at 3 and 6 months. We will also evaluate preliminary efficacy by comparing the proportion of YMSM who test at least once during the 6-month pilot and the proportion who successfully link to a PrEP provider in the intervention versus control groups. RESULTS: Formative work is currently underway. The LYNX pilot RCT will begin enrollment in October 2018, with study results available in 2019. CONCLUSIONS: The LYNX app is one of the first mobile apps designed to increase HIV/STI testing and PrEP uptake among YMSM. As low-perceived risk is a barrier to HIV/STI testing and PrEP use among youth, the personalized risk assessment and interactive sexual diary in LYNX could assist YMSM in better understanding their HIV risk and providing motivation to test for HIV/STIs and initiate PrEP. Coupled with community-based recruitment, this novel mobile app has great potential to reach and engage YMSM not currently involved in care and increase rates of HIV/STI testing and PrEP uptake in this vulnerable population. TRIAL REGISTRATION: ClinicalTrials.gov NCT03177512; https://clinicaltrials.gov/ct2/show/NCT03177512 (Archived by WebCite at http://www.webcitation.org/73c917wAw). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/10659. SN - 1929-0748 UR - https://www.unboundmedicine.com/medline/citation/30681964/Developing_a_Mobile_App__LYNX__to_Support_Linkage_to_HIV/Sexually_Transmitted_Infection_Testing_and_Pre_Exposure_Prophylaxis_for_Young_Men_Who_Have_Sex_With_Men:_Protocol_for_a_Randomized_Controlled_Trial_ DB - PRIME DP - Unbound Medicine ER -
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