Mobile App (UPrEPU) to Monitor Adherence to Pre-exposure Prophylaxis in Men Who Have Sex With Men: Protocol for a User-Centered Approach to Mobile App Design and Development

Abstract

Background: Daily and on-demand pre-exposure prophylaxis (PrEP) has been well demonstrated to effectively prevent HIV acquisition for men who have sex with men (MSM). More than half of the MSM PrEP users in Taiwan prefer on-demand PrEP; however, on-demand PrEP is a complicated dosing regimen because this kind of dosing regimen requires pre- and post-coital dosing, and sex events are hard to anticipate. Although there are a growing number of mobile apps designed to improve access to HIV prevention services and HIV medication adherence, few mobile apps focus on the adherence to PrEP or are designed to accommodate a complicated, on-demand PrEP dosing schedule. Objective: The aim of this project is to evaluate the usability of a newly developed mobile app (UPrEPU app) to assist MSM PrEP users to self-monitor their adherence to either daily or on-demand PrEP using a user-centered scheme. Methods: This research will be conducted in two phases: app development and usability study. In the app development phase, we will first conduct formative research with end users and stakeholders by in-depth interviews; the results will output PrEP users’ and PrEP navigators’ personas as material used in the app conceptualization stage. PrEP navigators are individuals in healthcare system that help HIV-negative individuals who need assistance in accessing PrEP care. A low-fidelity prototype of the app feature will be formatted by applying a participatory design approach to engage PrEP users, designers and app developers in the design process of the app. Then a high-fidelity prototype of the app for usability study will developed and refined iteratively within the multidisciplinary team and new internal testers. Internal testers include the research team with experts in public health, infectious disease and industrial design, and a close network of the research team that is taking PrEP. In the usability study phase, we will enroll 70 MSM PrEP users and follow up for four months. The usability, feasibility and effectiveness of the adherence monitoring will be evaluated. Results: Refinement of the UPrEPU app is currently ongoing. The usability study commenced in May 2020.