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Feasibility and Acceptability of an mHealth-Based Approach as an HIV Prevention Strategy Among People Who Use Drugs on Pre-Exposure Prophylaxis

Authors Shrestha R, Altice FL, DiDomizio E, Sibilio B, Ranjit YS, Copenhaver MM

Received 31 October 2019

Accepted for publication 7 January 2020

Published 16 January 2020 Volume 2020:14 Pages 107—118


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Roman Shrestha, 1 Frederick L Altice, 2 Elizabeth DiDomizio, 2 Brian Sibilio, 3 Yerina S Ranjit, 2 Michael M Copenhaver 3

1Aasaman Nepal, HIV Prevention Group, Lalitpur, Nepal; 2Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA; 3Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA

Correspondence: Roman Shrestha
Asaman Nepal, HIV Prevention Group, Ring Road, Lalitpur 44700, Nepal
Tel +977-9849783132

Introduction: There has been increasing interest in the use of mHealth technology in health care. To our knowledge, however, there is a lack of empirical evidence on the utilization of text messaging services (short message service; SMS) for HIV prevention among opioid-dependent people who use drugs (PWUD). As part of our formative work, we conducted an in-depth feasibility and acceptability study on the use of SMS reminders for HIV prevention in this risk group.
Methods: Forty HIV-negative, opioid-dependent PWUD who are currently taking pre-exposure prophylaxis (PrEP) were enrolled in the study. Participants received daily PrEP text reminders and weekly HIV risk reduction-related messages, which were developed using a user-centered approach. Participants were assessed at baseline and immediately post-intervention. Following the post-intervention assessment, participants completed an in-depth qualitative interview.
Results: Feasibility of text messaging service was high, as assessed by participants’ willingness to receive text messages (100%), retention (95%), and successful delivery of text messages (97%). Results further showed that participants were satisfied and perceived the use of daily PrEP reminder text messages as valuable and acceptable [mean: 75.0 (range 0– 100)]. Whereas, acceptability for the weekly text messages on HIV risk reduction was 60.3 (± 15.6), with 58.3% recommending them for future use. Thematic data exploration revealed important information for understanding and refining SMS content as well as logistical preferences.
Conclusion: Our findings provide preliminary evidence of the feasibility and acceptability of a text messaging-based approach as a potential tool for primary HIV prevention to improve PrEP adherence and HIV risk reduction among this underserved population. HIV risk reduction text messages need further modifications to become more appealing, with participant feedback taken into consideration.

Keywords: opioid use disorder, pre-exposure prophylaxis, text messaging, mobile technology, HIV risk behaviors

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