Abstract

BackgroundThe number of youth living with HIV in the United States (US) continues to rise, and racial, ethnic, and sexual minority youth including young men who have sex with men (YMSM) and young transgender women (YTGW) bear a disproportionate burden of the HIV epidemic. Due to social and healthcare system factors, many YMSM and YTGW do not seek HIV testing services and are therefore less likely to be aware that they are infected. Mobile health technology (mHealth) has the ability to increase uptake of HIV testing among these populations. Thus, the mLab App—which combines HIV prevention information with a mobile phone imaging feature for interpreting at-home HIV test results—was developed to improve testing rates and linkage to care among Black, Latino, and other YMSM and YTGW living in New York City and Chicago and their surrounding areas.MethodsThis study is a three-arm randomized controlled trial among YMSM and YTGW aged 18–29 years. Participants are randomized to either the mLab App intervention including HIV home test kits and standard of preventive care, standard of preventive care only, or HIV home test kits and standard of preventive care only.DiscussionmHealth technology used for HIV prevention is capable of delivering interventions in real-time, which creates an opportunity to remotely reach users across the country to strengthen their HIV care continuum engagement and treatment outcomes. Specifically during the COVID-19 pandemic, mHealth technology combined with at-home testing may prove to be essential in increasing HIV testing rates, especially among populations at high-risk or without regular access to HIV testing.Trial registrationThis trial was registered with Clinicaltrials.gov (NCT03803683) on January 14, 2019.

Highlights

  • The number of youth living with HIV in the United States (US) continues to rise, and racial, ethnic, and sexual minority youth including young men who have sex with men (YMSM) and young transgender women (YTGW) bear a disproportionate burden of the HIV epidemic

  • The number of youth living with HIV in the United States (US) continues to rise, and the epidemic is exacerbated in racial, ethnic, and sexual minority youth who bear a disproportionate burden of the HIV epidemic

  • Reports show that 69% of new infections occur in young men who have sex with men (YMSM) and young transgender women (YTGW), and the epidemic is further magnified in Black and Latino youth [1,2,3,4,5,6,7,8,9,10,11,12]

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Summary

Methods

Design This study is a three-arm randomized controlled trial among YMSM and YTGW aged 18–29 years. The power and sample size calculations are based on a primary comparison between HIV testing rates in the mLab App arm (Arm 1) and the standard of care arm (Arm 2). Following enrollment into the study, participants randomized to the intervention arm (arm 1) are provided with the mLab App and 2 OraQuick tests. Participants in arms 1 and 3 receive an additional 2 OraQuick tests after their 6-month visit At their baseline appointment, all participants regardless of arm are sent an email or text with links to mobile-optimized online prevention information, including PrEP and HIV testing information that is found on the CDC website. Participants in the intervention arm (arm 1) upload a photo image of their OraQuick test, enabling the study team to cross reference self-report with the visual results. All analyses will use the ITT principle [42], which requires subjects’ data to be analyzed as randomized, regardless of whether they used the mLab App or not

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