Sexual Health App Research Articles

A Randomized Controlled Trial of a Digital Intervention to Improve the Sexual Health of Adolescent and Young Adult Male Emergency Department Patients

PurposeTo assess implementation outcomes and potential efficacy of a user-informed, theory-based digital health intervention developed to improve adolescent and young adult (AYA) male sexual health. MethodsWe conducted a pilot randomized controlled trial of sexually active male emergency department (ED) patients aged 14–21 years. Participants were randomized to the intervention (Dr. Eric, Emergency Room Interventions to improve Care) or usual care. Dr. Eric consists of an ED-based sexual health app followed by 3 months of interactive text messages. We assessed the feasibility, adoption, and fidelity among users. Condom use, defined as the number of sexual encounters with condoms divided by the total number of sexual encounters over the past 4 weeks, was the primary efficacy outcome. ResultsWe enrolled 119 patients; mean age was 17.9 years, 87% were Hispanic, and half used condoms at last intercourse. Dr. Eric demonstrated feasibility, with high rates of consent (86.2%) and follow-up (81.5%). Intervention participants found Dr. Eric acceptable, liking (86.2%) and recommending (87.9%) the program. 98% of intervention participants interacted with all five app modules; one-quarter opted out of text messaging. At 6-week follow-up, the intervention group more often used a condom compared to the control group [OR 3.57, 95% confidence interval (1.93, 6.60)], p < .001]; however, this significant difference did not sustain at 13 weeks. DiscussionDr. Eric was feasible to deliver and acceptable to male AYA patients. To our knowledge, Dr. Eric is the first intervention to demonstrate evidence of short-term efficacy for improving condom use among male AYA in the ED.

Digital Health App to Address Disparate HIV Outcomes Among Black Women Living in Metro-Atlanta: Protocol for a Multiphase, Mixed Methods Pilot Feasibility Study.

Cisgender Black women in the southern United States are at heightened risk for HIV and adverse sexual and reproductive health outcomes. Mobile health interventions that target HIV risk while being adapted to the needs and lived experiences of Black women are remarkably limited. The study aims to refine SavvyHER, a mobile app for HIV prevention, with Black women residing in high HIV incidence areas of Georgia and evaluate the feasibility, acceptability, and usability of SavvyHER. This paper describes the procedures implemented to conduct this research. Community-based participatory research tenets guide this multiphase study to finalize the development of what we hypothesize will be an effective, sustainable, and culturally relevant HIV prevention and optimal sexual health and reproductive wellness app for Black women. This multiphased, mixed methods study consists of 3 phases. The first phase entails focus groups with Black women to understand their preferences for the functionality and design of a beta prototype version of SavvyHER. In the second phase, an app usability pretest (N=10) will be used to refine and optimize the SavvyHER app. The final phase will entail a pilot randomized controlled trial (N=60) to evaluate the app's feasibility and usability in preparation for a larger trial. Findings from preliminary focus groups revealed educational content, app aesthetics, privacy considerations, and marketing preferred by Black women, thus informing the first functional SavvyHER prototype. As we adapt and test the feasibility of SavvyHER, we hypothesize that the app will be an effective, sustainable, and culturally relevant HIV prevention, sexual health, and reproductive wellness tool for Black women. The findings from this research substantiate the importance of developing health interventions curated for and by Black women to address critical HIV disparities. The knowledge gained from this research can reduce HIV disparities among Black women through a targeted intervention that centers on their health needs and priorities. DERR1-10.2196/42712.

Co-designing a Sexual Health App With Immigrant Adolescents: Protocol for a Qualitative Community-Based Participatory Action Research Study

Canada is one of the world's most ethnically diverse countries, with over 7 million individuals out of a population of 38 million being born in a foreign country. Immigrant adolescents (aged 10 to 19 years) make up a substantial proportion of newcomers to Canada. Religious and cultural practices can influence adolescents' sexual attitudes and behaviors, as well as the uptake of sexual and reproductive health (SRH) services among this population. Adolescence is a time to establish lifelong healthy behaviors. Research indicates an alarming gap in adolescents' SRH knowledge, yet there is limited research on the SRH needs of immigrant adolescents in Canada. The purpose of this study is to actively engage with immigrant adolescents to develop, implement, and evaluate a mobile health (mHealth) intervention (ie, mobile app). The interactive mobile app will aim to deliver accurate and evidence-based SRH information to adolescents. We will use community-based participatory action research to guide our study. This research project will be conducted in 4 stages based on user-centered co-design principles. In Stage 1 (Empathize), we will recruit and convene 3 adolescent advisory groups in Edmonton, Toronto, and Vancouver. Members will be engaged as coresearchers and receive training in qualitative and quantitative methodologies, sexual health, and the social determinants of health. In Stage 2 (Define and Ideate), we will explore SRH information and service needs through focus group discussions with immigrant adolescents. In Stage 3 (Prototype), we will collaborate with mobile developers to build and iteratively design the app with support from the adolescent advisory groups. Finally, in Stage 4 (Test), we will return to focus group settings to share the app prototype, gather feedback on usability, and refine and release the app. Recruitment and data collection will be completed by February 2023, and mobile app development will begin in March 2023. The mHealth app will be our core output and is expected to be released in the spring of 2024. Our study will advance the limited knowledge base on SRH and the information needs of immigrant adolescents in Canada as well as the science underpinning participatory action research methods with immigrant adolescents. This study will address gaps by exploring SRH priorities, health information needs, and innovative strategies to improve the SRH of immigrant adolescents. Engaging adolescents throughout the study will increase their involvement in SRH care decision-making, expand efficiencies in SRH care utilization, and ultimately improve adolescents' SRH outcomes. The app we develop will be transferable to all adolescent groups, is scalable in international contexts, and simultaneously leverages significant economies of scale. PRR1-10.2196/45389.

Female Sexual Dysfunction Resources: Women and Healthcare Providers Need More Options

ABSTRACT Introduction Female sexual dysfunction (FSD) is an orphaned field due to numerous barriers faced by both providers and patients. Internet platforms, such as mobile applications, are potential tools to overcome these barriers and improve patient access to education and management options for FSD. Objective The purpose of this review is to identify existing applications addressing female sexual health and evaluate their educational content and services. Methods We searched the internet and Apple App Store for key words including: “sexual wellness app for women”, “female sexual health app”, “best sex apps for women”, “sexual health for women”, “sexual health”, “sexual wellness”. A panel of female pelvic medicine and reconstructive surgery experts reviewed the apps for quality of content, scientific basis of provided information, interactivity, usability and whether they would recommend it as a reference tool for patients. Results Of the 204 apps identified, 182 were excluded based on unrelated content (sex frequency trackers, ovulation trackers, sex games for couples, etc.). Two applications did not work and three were meant to be used with a vibrator. Total of 17 apps were analyzed and divided into five categories: educational (6), emotions and communication (2), relaxation and meditation (4), general sexual health (2), and social and fun (3). Among these 17 apps, eight required either a one-time payment ($4.99- 9.99) or annual subscription ($23-120) and two apps were advertisement driven. The apps from the educational category were reviewed in further details. All of the educational apps provided scientific information in collaboration with health experts, however only three offered interactive features. When assessed for usability, one app received good (70) and five received excellent (97.5) scores based on the System Usability Scale (SUS). The majority of the apps (5) provided information on pathology and treatments of orgasmic dysfunction, but only one app, created by a physician, provided information on all categories of female sexual dysfunctions. The reviewers identified only one app that they would recommend as a credible resource for patients to use. Conclusions Internet apps provide an ideal platform for women to learn about sexual health and female sexual dysfunction, which is rarely addressed by their healthcare providers. Apps may also serve as a valuable reference for providers. Our review of relevant apps available on the Apple App Store revealed only six with evidence-based information, and only one that would be recommended to patients by experts in the field. Clearly, there is a need for more accessible, educational resources addressing female sexual dysfunction for patients and providers. Disclosure No

Examining the Information Systems Success (ISS) of a mobile sexual health app (MyPEEPS Mobile) from the perspective of very young men who have sex with men (YMSM)

ObjectiveThe widespread and frequent use of mobile technology among adolescents, including sexual minority adolescents, presents an opportunity for the development of mobile health (mHealth) technology to combat the continuing HIV epidemic among young men who have sex with men (YMSM). We analyzed perceptions of the quality and impact of an HIV prevention mobile app on sexual risk reduction among YMSM. MethodsParticipants were recruited from a larger randomized controlled trial of the MyPEEPS Mobile app among YMSM aged 13–18 years. Data were collected via semi-structured interviews to assess quality and user satisfaction with MyPEEPS Mobile app using analysis informed by the Information Systems Success framework. Interview data were transcribed verbatim and analyzed using six themes: information quality, net benefit, user satisfaction, product quality, service quality, and health care barriers. ResultsInterviews were conducted with 40 YMSM (45% Hispanic; 80% non-White; 88% non-rural resident; 28% aged 17 years). Participants’ responses indicated that information quality was high, reporting that the app information was concise, easy to understand, useful, and relevant to their life. The net benefits were stated as improvements in their decision-making skills, health behaviors, communication skills with partner(s), and increased knowledge of HIV risk. There was general user satisfaction and enjoyment when using the app, although most of the participants did not intend to reuse the app unless new activities were added. Participants expressed that the product quality of the app was good due to its personalization, representation of the LGBTQIA + community, and user-friendly interface. Although no major technical issues were reported, participants suggested that adaption to a native app, rather than a web app, would improve service quality through faster loading speed. Participants also identified some health care barriers that were minimized by app use. ConclusionsThe MyPEEPS Mobile app is a well received, functional, and entertaining mHealth HIV prevention tool that may improve HIV prevention skills and reduce HIV risk among YMSM.

Sexual and reproductive health mobile apps: results from a cross-sectional values and preferences survey to inform World Health Organization normative guidance on self-care interventions

ABSTRACT Mobile application (app) platforms have the potential to advance sexual and reproductive health (SRH). Yet there is a dearth of knowledge regarding global perspectives from healthcare providers on how SRH mobile apps are being leveraged in their healthcare practice. In 2019 the World Health Organization (WHO) developed a consolidated guideline on self-care interventions for SRH. To inform this guideline, we conducted a global values and preferences survey. This study aimed to (a) understand the awareness, access, and uptake of SRH mobile apps; (b) examine how many healthcare provider (HCP) participants provided linkages, referrals and information to clients regarding SRH mobile apps; and (c) among HCP, assess how many felt confident and informed regarding SRH mobile apps. We hosted a cross-sectional web-based survey on the WHO Department of Reproductive Health and Research website and shared the survey with SRHR listservs. There were 825 survey participants, 360 whom identified as healthcare providers (HCP). Approximately one-third of HCP participants had provided a referral/information to their clients about sexual or reproductive health apps. While 40.8% of HCP felt confident and informed about sexual health apps, half (47.4%) reported needing more information, and 15.6% expressed interest in receiving training to use in practice. While 42.6% of HCPs felt confident and informed about reproductive health apps, 45.7% needed more information, and 15.1% were interested in further training. There was also an open-ended question for HCP to share their thoughts about self-care SRH interventions. Specifically regarding SRH apps, HCP responses revealed the importance of considering: (a) security and confidentiality; (b) potential benefits of SRH apps for underserved groups (i.e. youth, rural communities); (c) community engagement; (d) health benefits; and (e) and online training for HCP on SRH mobile apps. Findings signal interest and opportunities for training and engaging HCP in using mobile apps to advance SRH.

Dating apps as public health ‘problems’: cautionary tales and vernacular pedagogies in news media

ABSTRACT In this paper we examine how popular media reporting positions dating and hookup app use as a ‘social problem’ that impacts on health and wellbeing. The paper adopts a mixed-methods media studies approach to create and analyse a dataset of over 6,000 international news articles published within a 12-month period, drawing on thematic content analysis and inductive and deductive techniques. These analyses are framed in relation to online consultations with Australian sexual health professionals and app users. Applying Briggs and Hallin’s theory of biocommunicability (2007) – which proposes that contemporary health professionals’ scientific framing of public health problems are, in part, shaped by popular media discourses – we identify a significant category of supportive discussions of safer app use within social news and lifestyle reporting. This discursive space features what we have termed ‘vernacular pedagogies’ of app use, revealing app users’ safety strategies, and their experiences of pleasure and playfulness. We argue that an analysis of popular media can provide valuable insights into how everyday experiences of safety, risk and wellbeing are being shaped and contested with dating and hookup app use, and that these insights can be used to develop meaningful health promotion strategies.

A Mobile Sexual Health App on Empowerment, Education, and Prevention for Young Adult Men (MyPEEPS Mobile): Acceptability and Usability Evaluation.

BackgroundHIV incidence among young adult men who have sex with men (MSM), particularly among black and Latino men, continues to rise. As such, continued HIV prevention interventions for young MSM of color are of utmost importance. Male Youth Pursuing Empowerment, Education and Prevention around Sexuality (MyPEEPS) Mobile is a comprehensive HIV prevention and sexual health education smartphone app initially created to promote sexual health and HIV prevention among adolescent sexual minority young men aged 13 to 18 years.ObjectiveThe objective of this study was to critically appraise the acceptability and usability of MyPEEPS Mobile for young adult MSM aged 19 to 25 years.MethodsStudy participants used the mobile app, completed usability questionnaires and in-depth interviews, and reported their experience using the app. Analysis of interview data was guided by the Unified Theory of Acceptance and Use of Technology (UTAUT) to better understand the usability and acceptability of this intervention for young adults. Interview data were coded using the following constructs from the UTAUT model: performance expectancy, effort expectancy, and social influence.ResultsA total of 20 young adult MSM (n=10 in Chicago, Illinois, and n=10 in New York, New York) were enrolled in the study. Participants reported that MyPEEPS Mobile was free of functional problems (Health Information Technology Usability Evaluation Scale scores and Post-Study System Usability Questionnaire scores consistent with high usability), easy to use, and useful, with an engaging approach that increased acceptability, including the use of avatars and animation, and inclusive representation of the diverse identities by race and ethnicity, gender identity, and sexual orientation. Recommended areas for improving MyPEEPS Mobile for the target demographic included more adult-oriented graphics, advanced educational content, scenarios for youth with more sexual experience, and search function to increase accessibility of key content.ConclusionsOverall, young adult MSM aged 19 to 25 years described the MyPEEPS Mobile as educational, informative, and usable for their sexual health education and HIV prevention needs, and they provided actionable recommendations to optimize its use and applicability for this age group.

Love My Body: Pilot Study to Understand Reproductive Health Vulnerabilities in Adolescent Girls.

BackgroundSexually transmitted infections (STIs) are on the rise in the United States, and adolescent girls (15-19 years old) are more susceptible to acquiring STIs than their male peers. The co-occurrence of alcohol use and sexual risk taking contribute significantly to STI acquisition. Mobile health (mHealth) interventions are ideally suited for our target population and have demonstrated increases in STI testing in young people, as well as reductions in alcohol use.ObjectiveThis pilot study used both qualitative and quantitative methods to explore the views of adolescent girls (age range 15-19 years old; 74.6%, 279/374 white) on the desired qualities and content of an mHealth app for sexual health.MethodsWe conducted nine 60-min in-depth interviews (IDIs) to gather information and identify themes of sexual health and alcohol use, and we tested the feasibility of using a two-week social media campaign to collect survey information regarding sexual health risk in adolescent girls.ResultsWe iteratively coded IDIs and identified major themes around pressure of alcohol use, lack of STI knowledge, male pressure to not use condoms, and pregnancy as a worse outcome than STIs. Results from the web-based survey on risky health behaviors, which was completed by 367 participants, support the use of a sexual health app designed for girls.ConclusionsFuture work will integrate these themes to inform the development of a culturally sensitive mHealth app to prevent STIs among adolescent girls.

Development of a Mobile Phone App to Promote Safe Sex Practice Among Youth in Stockholm, Sweden: Qualitative Study.

BackgroundMobile health (mHealth) has been shown to be effective in increasing knowledge of sexual health among youth. To date, evaluations mostly refer to interventions delivered via computer, email, and text messages. The possibility of downloading apps on mobile devices has opened up opportunities to develop engaging interventions on safe sexual health promotion. To attract young users and have them engage with a sexual health app, it is important to involve youth in intervention development.ObjectiveThis study aimed to obtain input from youth on the content of a mobile phone app intended to promote safe sex and increase condom use among youth in Stockholm.MethodsThis study was conducted at the Youth Health Clinics (YHC) in Stockholm County, Sweden. A total of 15 individual in-depth interviews and 2 focus group discussions (with youth aged 18-23 years) were conducted at the YHC in Stockholm. Areas explored were: (1) youth perceptions of condom use (advantages and obstacles), (2) perceptions of mHealth to promote safe sexual practices, and (3) content development for a mobile phone app to promote safe sex.ResultsThe smartphone app was developed based on the categories that emerged from the data. With regard to content, youth requested sex education, including information on sexually transmitted infections. In addition, condom-specific information, including practical usage technique, advice on how to have the condom talk, and how to decrease shame related to condom use, was requested. Youth suggested different modes to deliver the content, including text messages, movie clips, and push notifications. It was suggested that the tone of the messages delivered should be fun, entertaining, and supportive. The inputs from youth influenced the development of the following sections of the app: Condom Obstacles and Solutions; Quiz; Games; Self-Refection; Challenges; Stories by Peers (stories from peers and information from a doctor); Condom Tips, Pep Talk, and Boosting; and Random Facts.ConclusionsIt is important to use input from youth when developing a smartphone intervention since the success of the intervention largely depends on the level of engagement and usage by youth. Furthermore, if proven efficient in increasing condom use, it is important that the development, including content and mode, is thoroughly described so that the intervention can be replicated. Likewise, if proven inefficient, it is important to learn from mistakes to improve and adjust the intervention. The effect of this smartphone app on safe sexual practices among youth is being evaluated in a pragmatic randomized controlled trial in Stockholm (ISRCTN13212899) and will be reported separately.

The use of technology in the sexual health education especially among minority adolescent girls in the United States

The purpose of this review is to examine current sexual health education technologies for adolescents and identify gaps in knowledge. Disparities in sexual health education are prominent and mainly affect young women of color. As a result, the use of technology to reach these marginalized populations could potentially invoke change. Thus, it is crucial to determine the viability of technology as a mechanism to bridge the knowledge gap regarding sexual health for adolescents that are most at risk of sexually transmitted infections and unwanted pregnancies. With a lack of standardized, evidenced-based sexual health education programs in the United States, the future of comprehensive sexual health education is moving toward smartphone apps. Many sexual health technologies exist that target adolescents, most of which have been proven to demonstrate positive effects. Use of mobile apps, especially for vulnerable populations, can be more effective because of privacy and widespread dissemination. Ultimately, more research needs to be conducted to determine the most effective content for these sexual health apps. Additionally, more research should be conducted on effective sexual health apps for marginalized populations to determine whether technology is a viable solution.

Preferences for Sexual Health Smartphone App Features Among Gay and Bisexual Men.

Given the popularity of geosocial networking applications ("apps") among gay, bisexual, and other men who have sex with men (GBMSM), this study sought to examine GBMSM's willingness to use sexual health and behavior tracking features if integrated within apps they are already using to meet sexual partners. Most GBMSM (91%) recruited on a popular app reported interest in one or more sexual health app features, including features to find LGBT-friendly providers (83%), receive lab results (68%), schedule appointment reminders (67%), chat with a healthcare provider (59%), and receive medication reminder alerts (42%). Fewer GBMSM were interested in tracking and receiving feedback on their sexual behavior (35%) and substance use (24%). Our data suggest that integrating sexual health and behavior tracking features for GBMSM who use apps could be promising in engaging them in HIV prevention interventions. Further research is needed on GBMSM's perspectives about potential barriers in using such features.

Sexual health in your hands: How the smartphone apps can improve your sexual wellbeing?

Summary In recent years, the numbers of smartphone users has surged across the world and downloads of smartphone apps have grown significantly, with smartphone usage increased to 73% among American adolescents since 2013. The main goal of this article is to present a review of the literature focusing the use of smartphone applications to improve sexual health. Using a smartphone application to provide sexual health information, especially to younger populations, might aid in increasing awareness of sexual risk behaviors before sexual debut. Providing accurate, comprehensive, and up-to-date sexual health education materials through smartphones vs websites might improve their sexual health outcomes. However, there are few smartphone applications related to sexual and reproductive health that are available to users. Research has shown that 80% of Internet users in the United States search online for health information, and that young people are gathering health information using mobile devices with increasing frequency, including sexual health information. However, while new technologies, including smartphone apps, are used to facilitate health information seeking, health-related apps are infrequently downloaded and rarely used. This suggests that, to promote sexual health through smartphone apps, researchers could partner with app developers in order to integrate sexual health promotion interventions in popular sex-related or dating apps. However, it is evident that these apps provide novel opportunities to engage at-risk populations in sexual health interventions. Several studies have suggested that young adults consider sexual health promotion via apps acceptable. Future research should focus on evaluating these efforts specifically in the reduction of negative sexual health consequences such as a decrease of STIs and unintended pregnancies as well as whether a sexual health app can link clients to health services. Our results could help clinicians by offering information about the potential use of smartphone apps to increase sexual health.

Developing a sexual health app: Time for review

In her regular column, Alison Menzies shares her experiences as a research scholarship holder and on the development of an app aimed at young offenders.

Designing a sexual health app: What's in a name?

In her regular column, Alison Menzies shares her experiences as a research scholarship holder and on the development of a sexual health app aimed at young offenders.

P5.058 A Review of the Landscape of Mobile-Phone Applications For Information, Education, Diagnosis, Care and Self-Management of Sexually Transmitted Infections (STIs)

BackgroundMobile phone applications (apps), which offer a paradigm shift in healthcare, have potential to transform sexually transmitted infection (STI) prevention and management. Currently, few sexual health related apps exist for...