Shrestha, R., Maviglia, F., Altice, F., DiDomizio, L., Khati, A., Mistler, C., Azwa, I., Kamarulzaman, A., Ab Halim, M.A., & Wickersham, J.
JMIR, May 2022. Abstract
Background: Background: The growth in mobile technology access, utilization, and services holds great promise to facilitate HIV prevention efforts in Malaysia. Despite these promising trends, there is a dearth of evidence on the use of mHealth platforms to address HIV prevention needs of Malaysian gay, bisexual, and other men who have sex with men (GBMSM).
Objective: The goal of this study was to gain insights into: a) access and utilization of communication technology (e.g., landline phone, internet, cell phone); b) acceptability of mHealth-based interventions for HIV prevention services; and c) preferences regarding the format and frequency of mHealth interventions among Malaysian GBMSM.
Methods: A cross-sectional survey of 376 Malaysian GBMSM was conducted between July 2018 and March 2020. Participants were recruited using respondent-driven sampling (RDS) in the Greater Kuala Lumpur region, Malaysia. Participants completed a self-administered assessment of participant demographics, HIV risk-related behaviors, access to and frequency of use of communication technology, and acceptability of mHealth for HIV prevention.
Results: Almost all participants owned or had access to a smartphone with Internet access (97.9%) and accessed the Internet daily (99.2%), mainly on a smartphone (88.8%). Using a 5-point scale, participants on average used smartphones primarily for social networking (M=4.5; SD=0.8), followed by sending or receiving emails (M=4.0; SD=1.0) and searching for health-related information (M=3.5; SD=0.9). Further, the results indicated high acceptance of mHealth for HIV prevention (M=4.1; SD=1.5), including: receiving HIV prevention information (91.8%); receiving medication reminders (89.4%); screening and monitoring sexual activity (81.4%) and illicit drug use (74.7%); and monitoring drug cravings (74.5%). Participants overwhelmingly preferred a smartphone app over other modalities (e.g., text, phone call, email) for engaging in mHealth HIV prevention tools. Acceptance of mHealth was higher for those who were university graduates, living in a relationship with a partner, engaged in sexualized drug use, and engaged in receptive anal sex.
Conclusions: Findings from this study provide support for developing and deploying mHealth strategies for HIV prevention in GBMSM using a smartphone app, crucial for a key population with suboptimal engagement in HIV prevention and treatment.