Center For AIDS Research

Valeria Cantos, MD

Funded by: CFAR Adelante

Project Period: 8/1/19 - 7/31/21



Development of a Comprehensive Prevention App for Latino MSM

Project Summary
Latino men who have sex with men (LMSM) represent the only ethnic group in the US with increasing incidence of HIV in the United States, indicating a substantial need for novel HIV prevention interventions. Despite this need, LMSM face distinctive HIV prevention barriers, especially in "new host" communities like Atlanta, where social support is limited. Our formative research identified specific barriers for LMSM, including: scarcity of reliable, bilingual, and culturally-responsive sources of HIV prevention information, difficulties accessing HIV testing/PrEP delivery services and navigating the healthcare system, perceived provider-related judgement/homophobia, language barriers, feeling uncomfortable/distrustful with non-Latinx clinicians and staff, avoidance of HIV- and PrEP-related discussions in social settings, and privacy concerns when attending sexual health clinics. For undocumented LMSM, poverty, lack of insurance, and fear of deportation are added barriers. Seeking to overcome these barriers, we propose developing a culturally-responsive HIV prevention app (SaludFindr), using Healthmindr, an existing comprehensive HIV prevention app, as baseline platform. HealthMindr includes multiple self-assessments, which direct users into customized menus of appropriate services: PrEP service locator, mail delivery of condoms, lubricant, and home HIV testing kits, and customizable HIV testing plans (including frequency, testing locator, and HIV testing methods). During a pilottesting study, HealthMindr was found usable and acceptable by mostly White and Black MSM. Based on the ADAPT-ITT framework, we will first conduct a formative evaluation documenting LMSM's opinions on potential changes to Healthmindr's domains and added new functionalities based on our formative research, through six focus group discussions. We will use this information and the guidance from our partner community-based organization, Latino LinQ, to create an initial set of images that display the functional elements of the app called "wireframes." We will present these wireframes to LMSM during two theater test "walkthroughs" and modify them based on their feedback. Data from the theater tests will guide the creation of an app development plan. Once the new app is produced, we will conduct a pilot-testing study to evaluate its usability and acceptability, using a standardized usability scale and calculations derived from app tracking data. We will set specific usability and acceptability thresholds that, if met, will allow us to conduct future research in a clinical trial setting to compare the efficacy of SaludFindr relative to HealthMindr and to standard of care in promoting HIV preventive actions in LMSM.

Relevance
While new HIV diagnoses in African American MSM are stabilizing and are decreasing in White MSM, HIV incidence in LMSM is increasing in the United States (US). LMSM face unique social and structural barriers to access HIV prevention services. Innovative strategies to overcome such barriers are urgently needed in this population.