Clinic-Integrated mHealth Intervention (“JomPrEP” App) to Improve Uptake of HIV Testing and Pre-exposure Prophylaxis among Men Who Have Sex with Men in Malaysia: Protocol for Intervention Development and Multi-Phase Trial (Preprint)

Abstract

Men who have sex with men (MSM) are disproportionately affected by the HIV epidemic in Malaysia and globally. Cross-cutting prevention strategies like mHealth, particularly smartphone apps, hold great promise for HIV prevention efforts among Malaysian MSM, especially when linked to HIV testing and pre-exposure prophylaxis (PrEP).

This study aimed to adapt an existing app to create and test a clinic-integrated app (“JomPrEP”), a virtual platform to deliver HIV testing and PrEP services for MSM in Malaysia.

The JomPrEP project involves developing and testing an app-based platform for HIV prevention among Malaysian MSM and will be conducted in two phases. In Phase I (Development Phase), we will adapt an existing mHealth app (“HealthMindr”) to create a new clinic-integrated app called “JomPrEP” to deliver holistic HIV prevention services (e.g., HIV testing, PrEP, support services for mental health and substance use) among MSM in Malaysia. During Phase II (Testing Phase), we will utilize a Type I Hybrid Implementation Science trial design to test the efficacy of JomPrEP while gathering information on implementation factors to guide future scale-up in real-world settings.

As of September 2022, we have completed Phase I of the proposed study. Based on a series of formative work completed during Phase I, we developed a fully functional, clinic-integrated JomPrEP app, which provides a virtual platform for MSM in Malaysia to facilitate their engagement in HIV prevention in a fast and convenient manner. Based on participant feedback provided during Phase I, we are currently optimizing JomPrEP and the research protocols for a large-scale efficacy trial (Phase II), which will commence in January 2023.

Scant HIV prevention resources coupled with entrenched stigma, discrimination, and criminalization of same-sex sexual behavior and substance use hamper access to HIV prevention services in Malaysia. If found efficacious, JomPrEP can be easily adapted for a range of health outcomes and healthcare delivery services for MSM, including adaptation to other low- and middle-income countries (LMICs).

NCT05325476