Abstract
BackgroundEncouraging consistent use of pre-exposure prophylaxis (PrEP) is essential for reducing HIV incidence, particularly among gay, bisexual, and other men who have sex with men (GBM), and especially those who engage in heavy drinking. Although practice guidelines recommend providing adherence counseling to PrEP patients, clinics and providers may not have the resources or expertise to provide it. Internet-facilitated interventions have been shown to improve HIV prevention outcomes, including medication and care adherence. Game Plan is a website we created to help users make a tangible plan for reducing their HIV risk. We designed additional components of Game Plan to address key individual level barriers to PrEP use.ObjectiveThe aim of this mixed methods research is to test the usability and user experience of these components with intended users: GBM who drink heavily and are on PrEP.MethodsIn study 1 (usability), we completed a detailed individual interview in which participants (n=10) walked through a prototype of the website, thinking aloud as they did, and completed a follow-up interview and web-based survey afterward. Study 2 (user experience) involved providing participants (n=40) with a link to the prototype website to explore on their own and asking them to complete the same follow-up survey afterward. Qualitative data were analyzed using thematic analysis, and descriptive statistics were used to analyze quantitative data.ResultsUsers in both studies gave the website excellent ratings for usability, overall satisfaction, and quality, and most often described the site as informative, helpful, and supportive. Users also rated the site’s content and feel as respectful of them and their autonomy, empathetic, and they stated that it conveyed confidence in their ability to change. The study 1 interviews highlighted the importance of the website’s esthetics to the participants’ engagement with it and its credibility in prompting genuine reflection.ConclusionsGBM who reported heavy drinking and used PrEP generally found a website focused on helping them to create a plan to use PrEP consistently to be helpful. Adopting user-centered design methods and attending to the esthetics of mobile health interventions are important steps toward encouraging engagement and reducing at-risk behaviors.
Highlights
Medications approved for use as HIV pre-exposure prophylaxis (PrEP) have considerable promise of reducing overall HIV incidence [1,2], among groups who are at a higher risk of HIV such as gay, bisexual, and other men who have sex with men (GBM) [3]
We explored the usability and user experience (UX) of a redesigned version of Game Plan among GBM who drink heavily and who were currently taking PrEP
Specific findings suggesting lack of clarity or usability problems with certain components led us to make many specific changes to the site design and interfaces before we began using Game Plan in 2 trials testing its efficacy in improving PrEP outcomes and HIV risk
Summary
Medications approved for use as HIV pre-exposure prophylaxis (PrEP) have considerable promise of reducing overall HIV incidence [1,2], among groups who are at a higher risk of HIV such as gay, bisexual, and other men who have sex with men (GBM) [3]. Encouraging consistent use of pre-exposure prophylaxis (PrEP) is essential for reducing HIV incidence, among gay, bisexual, and other men who have sex with men (GBM), and especially those who engage in heavy drinking. Conclusions: GBM who reported heavy drinking and used PrEP generally found a website focused on helping them to create a plan to use PrEP consistently to be helpful. Adopting user-centered design methods and attending to the esthetics of mobile health interventions are important steps toward encouraging engagement and reducing at-risk behaviors
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