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
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
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DOI：
10.2196/10659
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发表时间：
2019-01-01
影响因子：
1.7
通讯作者：
Scott, Hyman
中科院分区：
文献类型：
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作者：
Liu, Albert;Coleman, Kenneth;Scott, Hyman
背景：在美国，男男性行为者(YMSM)是艾滋病毒和性传播感染(STI)发病率最高的人群之一，而HIV和STI检测和暴露前预防(PrEP)的接种率最低。目的：本项目的目标是开发和完善Lynx这一新型移动应用程序，以支持美国YMSM与HIV/STI检测和PrEP服务的联动，并在试点随机对照试验(RCT)中评估Lynx的可接受性和可行性。方法：本研究方案将分3个阶段进行：20名YMSM中一系列3个焦点小组的迭代开发阶段，以完善Lynx应用程序；在15名YMSM中进行开放式技术试点，以优化该应用程序的可用性；然后在60名有感染艾滋病毒风险的未感染艾滋病毒的YMSM中进行为期6个月的试点随机对照试验。Lynx应用程序使用信息、动机和行为技能理论模型开发，包括跟踪性行为的电子日记(信息)、个性化风险评分以促进准确的风险感知(信息/动机)、测试提醒(动机/行为技能)、访问基于家庭的HIV/STI检测选项和基于地理空间的HIV/STI检测护理站点(行为技能)。可行性和可接受性将在3个月和6个月时通过APP对使用模式的分析和通过计算机辅助自访进行的可接受性量表进行评估。我们还将通过比较干预组和对照组中至少测试一次的YMSM的比例和成功连接到PrEP提供者的比例来评估初步疗效。结果：目前正在进行形成工作。Lynx试验RCT将于2018年10月开始注册，研究结果将于2019年公布。结论：Lynx应用程序是首批旨在提高青年男性接触者HIV/STI检测和PrEP接受率的移动应用程序之一。由于低感知风险是青少年进行艾滋病毒/性传播感染检测和使用PrEP的障碍，Lynx的个性化风险评估和互动性日记可以帮助YMSM更好地了解他们的艾滋病毒风险，并提供动力来检测艾滋病毒/性传播感染和发起PrEP。再加上基于社区的招募，这款新型移动应用程序具有巨大的潜力，可以接触到目前没有参与护理的YMSM，并提高这一弱势群体的艾滋病毒/性传播感染检测和PrEP接受率。
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.