Exploring Perceived Utility of a Clinic-Integrated HIV Prevention App for Men Who Have Sex With Men in Malaysia: A Qualitative Think-Aloud Study.

Abstract

HIV remains a global health concern, disproportionately affecting men who have sex with men (MSM). Discrimination, stigma, and other barriers in healthcare settings are common issues for MSM in Malaysia, resulting in sub-optimal HIV testing and linkage to HIV prevention services. Thus, we created a clinic-integrated HIV prevention app called "JomPrEP" to scale up HIV prevention efforts among this vulnerable group. This study aimed to explore the perceived utility, appeal, and functionality of the JomPrEP app for MSM in Malaysia to improve access to HIV prevention services. We conducted one-on-one qualitative interviews with 10 MSM and 10 healthcare stakeholders (i.e., physicians and administrators) using the 'think-aloud' (TA) protocol. A brief example was provided to ensure participants understood the TA process, and then they were asked to open the app's web version in their browsers and share their screens. The TA procedure included 10 problem-solving tasks, followed by a semi-structured interview. These interviews aimed to delve deeper into the users' feedback on the pre-specified tasks on nine features of the app. The TA sessions were video-recorded and then transcribed verbatim. Theme analysis was used to analyze qualitative data. MSM and stakeholder participants expressed most of the app features (e.g., app signup page, ordering HIV self-test [HIVST] kits, and pre-exposure prophylaxis [PrEP] medications) as being important and user-friendly. Incorporating other features, particularly MedManager (e.g., a feature that sends reminders to users and tracks their medications) and reward systems (i.e., incentives for specific actions such as ordering HIVST or reviewing app resources), were well-received. Conversely, participants also suggested (i.e., introducing edit and update options for PrEP and HIVST kit orders and incorporating confirmation messages for clinic appointments) to refine the app further. JomPrEP was found to be a functional, appealing, and useful platform to scale up HIV prevention services among MSM in Malaysia. Further refinements and pilot testing are needed to assess its impact on HIV prevention efforts for MSM in Malaysia.