Usability and effectiveness of adherence monitoring of a mobile app designed to monitor and improve adherence to event-driven and daily HIV pre-exposure prophylaxis among men who have sex with men in Taiwan

Author:

Wu Huei-Jiuan1,Yu Yi-Fang2,Ku Stephane Wen-Wei34,Tseng Yuan-Chi5ORCID,Yuan Chien-Wen6,Li Chia-Wen7,Huang Po-Hsien8,Ko Nai-Ying29,Anderson Peter L.10,Strong Carol2ORCID

Affiliation:

1. UNSW Sydney, The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia

2. Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan

3. Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

4. Division of Infectious Diseases, Department of Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan

5. Institute of Service Science, National Tsing Hua University, Hsinchu, Taiwan

6. Graduate Institute of Library & Information Studies, National Taiwan Normal University, Taipei, Taiwan

7. Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

8. Department of Psychology, National Chengchi University, Taipei, Taiwan

9. Department of Nursing, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan

10. Department of Pharmaceutical Sciences, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, USA

Abstract

Objective The UPrEPU mobile app is a self-monitoring system to enable men who have sex with men to optimize their pre-exposure prophylaxis adherence for HIV prevention. The app was designed to accommodate a rather complicated event-driven dosing schedule. We aim to evaluate the usability of the UPrEPU app and its effectiveness in improving adherence monitoring. Methods From May to October 2020, 35 participants were enrolled for the usability study and followed up for 4 months. Blood samples for the drug concentration in the dried blood spots were obtained once during the second to fourth follow-up visits. The effectiveness of adherence monitoring was analyzed using Cohen's kappa statistic to calculate the concordance between the average number of pills taken and drug concentration in the dried blood spots. Results Overall retention was 91.4% (32 participants) at the end of the study. Participants used the app for a mean of 29 days and made 2565 data entries in total, with an average of 76 data entries. The average systematic usability scale score for the app was 71.5, indicating acceptable usability. Slight agreement was reached between the dried blood spots measurement and the number of pills taken and recorded in the app (weighted kappa: 0.21). Conclusions Our user-centered UPrEPU app demonstrated that it could accommodate both daily and event-driven dosing schedules for men who have sex with men clients with acceptable usability scores. We confirmed that complex behaviors such as different drug-dosing regimens that are contingent on sexual behaviors could be incorporated into the design of a mobile app.

Funder

Taiwan Ministry of Health and Welfare, Centers for Disease Control

Taiwan Ministry of Science and Technology

Publisher

SAGE Publications

Subject

Health Information Management,Computer Science Applications,Health Informatics,Health Policy

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