Acceptability of the LetSync Application Wireframes to Improve HIV Care Engagement and Treatment among Sexual Minority Men in Couples: Findings from a Qualitative Study (Preprint)

Abstract

HIV disparities continue to be a significant challenge impacting Black Sexual Minority Men (SMM) in the US. Inadequate engagement and retention of patients in HIV care has been associated with poor health outcomes. Interventions to improve sustained commitment to HIV care are needed. Mobile health (mHealth) interventions can help facilitate access to and utilization of HIV health services, particularly among individuals at risk for disengaging with care.

We designed the LetSync application (app) wireframes for a mHealth intervention using a couples-centered design approach to improve HIV engagement and treatment among Black SMM and their partners. The objective of this study was to test the app wireframes, gauge future app user interest, and elicit information that could be used to inform processes for designing the LetSync app.

We conducted in-depth interviews with Black SMM (n=24) to assess acceptability of the LetSync app wireframes between May 2020 and January 2021. Participants reviewed the LetSync app wireframes and provided feedback regarding perceived usefulness, interest in future app use, and suggestions for improvement.

Participants indicated interest in the future LetSync app and noted that the wireframes features were acceptable and usable. In our study, the future LetSync app was frequently referred to as a potential resource that could help facilitate users’ engagement in HIV care through the following mechanisms: 1) enable scheduling of appointments and timely reminders for clinic visits, 2) help improve HIV medication adherence, 3) encourage and motivate participants to ask questions from their healthcare provider and stay engaged in conversations during clinic visits, 4) facilitate effective communication by assisting couples with planning, coordination, and management of daily routines, 5) help participants understand their partner’s health needs, including access to and utilization of health care services, and 6) facilitate participants’ ability to improve their relationship skills, partner support, and self-efficacy in managing conflict. In addition to near universal interest in potential daily app use, study participants indicted that they would recommend the LetSync app to other family members, friends, and people in their social networks who are living with HIV.

Our findings revealed considerable interest in future app use for HIV care management, which could possibly increase the chance of the LetSync app being successfully adopted by Black SMM in couples. Due to its interactive and couples-centered approach, the LetSync app could help improve communication between Black SMM and their partners, as well as their health providers. Additionally, the LetSync app could provide an acceptable modality for these men to receive support in accessing HIV care services.

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