The Effects of MyChoices and LYNX Mobile Apps on HIV Testing and Pre-Exposure Prophylaxis Use by Young US Sexual Minority Men: Results From a National Randomized Controlled Trial
BackgroundYoung sexual minority men have among the highest rates of HIV in the United States; yet, the use of evidence-based prevention strategies, including routine HIV testing and pre-exposure prophylaxis (PrEP), remains low. Mobile apps have enormous potential to increase...
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JMIR Publications
2025-02-01
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| Series: | JMIR Public Health and Surveillance |
| Online Access: | https://publichealth.jmir.org/2025/1/e63428 |
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| author | Katie B Biello Kenneth H Mayer Hyman Scott Pablo K Valente Jonathan Hill-Rorie Susan Buchbinder Lucinda Ackah-Toffey Patrick S Sullivan Lisa Hightow-Weidman Albert Y Liu |
| author_facet | Katie B Biello Kenneth H Mayer Hyman Scott Pablo K Valente Jonathan Hill-Rorie Susan Buchbinder Lucinda Ackah-Toffey Patrick S Sullivan Lisa Hightow-Weidman Albert Y Liu |
| author_sort | Katie B Biello |
| collection | DOAJ |
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BackgroundYoung sexual minority men have among the highest rates of HIV in the United States; yet, the use of evidence-based prevention strategies, including routine HIV testing and pre-exposure prophylaxis (PrEP), remains low. Mobile apps have enormous potential to increase HIV testing and PrEP use among young sexual minority men.
ObjectiveThis study aims to assess the efficacy of 2 theory- and community-informed mobile apps—LYNX (APT Mobility) and MyChoices (Keymind)—to improve HIV testing and PrEP initiation among young sexual minority men.
MethodsBetween October 2019 and May 2022, we implemented a 3-arm, parallel randomized controlled trial in 9 US cities to test the efficacy of the LYNX and MyChoices apps against standard of care (SOC) among young sexual minority men (aged 15-29 years) reporting anal sex with cisgender male or transgender female in the last 12 months. Randomization was 1:1:1 and was stratified by site and participant age; there was no masking. The co-primary outcomes were self-reported HIV testing and PrEP initiation over 6 months of follow-up.
ResultsA total of 381 young sexual minority men were randomized. The mean age was 22 (SD 3.2) years. Nearly one-fifth were Black, non-Hispanic (n=67, 18%), Hispanic or Latino men (n=67, 18%), and 60% identified as gay (n=228). In total, 200 (53%) participants resided in the Southern United States. At baseline, participants self-reported the following: 29% (n=110) had never had an HIV test and 85% (n=324) had never used PrEP. Sociodemographic and behavioral characteristics did not differ by study arm. Compared to SOC (n=72, 59%), participants randomized to MyChoices (n=87, 74%; P=.01) were more likely to have received at least 1 HIV test over 6 months of follow-up; those randomized to LYNX also had a higher proportion of testing (n=80, 70%) but it did not reach the a priori threshold for statistical significance (P=.08). Participants in both MyChoices (n=23, 21%) and LYNX (n=21, 20%) arms had higher rates of starting PrEP compared to SOC (n=19, 16%), yet these differences were not statistically significant (P=.52).
ConclusionsIn addition to facilitating earlier treatment among those who become aware of their HIV status, given the ubiquity of mobile apps and modest resources required to scale this intervention, a 25% relative increase in HIV testing among young sexual minority men, as seen in this study, could meaningfully reduce HIV incidence in the United States.
Trial RegistrationClinicalTrials.gov NCT03965221; https://clinicaltrials.gov/study/NCT03965221 |
| format | Article |
| id | doaj-art-2f4c653a5d0f4d02bb6ca87a6af076b5 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-02-01 |
| publisher | JMIR Publications |
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| spelling | doaj-art-2f4c653a5d0f4d02bb6ca87a6af076b52025-02-05T13:31:12ZengJMIR PublicationsJMIR Public Health and Surveillance2369-29602025-02-0111e6342810.2196/63428The Effects of MyChoices and LYNX Mobile Apps on HIV Testing and Pre-Exposure Prophylaxis Use by Young US Sexual Minority Men: Results From a National Randomized Controlled TrialKatie B Biellohttps://orcid.org/0000-0002-5017-5699Kenneth H Mayerhttps://orcid.org/0000-0001-7460-733XHyman Scotthttps://orcid.org/0000-0001-8775-7214Pablo K Valentehttps://orcid.org/0000-0002-2058-3472Jonathan Hill-Roriehttps://orcid.org/0000-0002-0393-1877Susan Buchbinderhttps://orcid.org/0000-0003-2404-0712Lucinda Ackah-Toffeyhttps://orcid.org/0000-0002-6756-6370Patrick S Sullivanhttps://orcid.org/0000-0002-7728-0587Lisa Hightow-Weidmanhttps://orcid.org/0000-0002-2421-923XAlbert Y Liuhttps://orcid.org/0000-0003-0320-823X BackgroundYoung sexual minority men have among the highest rates of HIV in the United States; yet, the use of evidence-based prevention strategies, including routine HIV testing and pre-exposure prophylaxis (PrEP), remains low. Mobile apps have enormous potential to increase HIV testing and PrEP use among young sexual minority men. ObjectiveThis study aims to assess the efficacy of 2 theory- and community-informed mobile apps—LYNX (APT Mobility) and MyChoices (Keymind)—to improve HIV testing and PrEP initiation among young sexual minority men. MethodsBetween October 2019 and May 2022, we implemented a 3-arm, parallel randomized controlled trial in 9 US cities to test the efficacy of the LYNX and MyChoices apps against standard of care (SOC) among young sexual minority men (aged 15-29 years) reporting anal sex with cisgender male or transgender female in the last 12 months. Randomization was 1:1:1 and was stratified by site and participant age; there was no masking. The co-primary outcomes were self-reported HIV testing and PrEP initiation over 6 months of follow-up. ResultsA total of 381 young sexual minority men were randomized. The mean age was 22 (SD 3.2) years. Nearly one-fifth were Black, non-Hispanic (n=67, 18%), Hispanic or Latino men (n=67, 18%), and 60% identified as gay (n=228). In total, 200 (53%) participants resided in the Southern United States. At baseline, participants self-reported the following: 29% (n=110) had never had an HIV test and 85% (n=324) had never used PrEP. Sociodemographic and behavioral characteristics did not differ by study arm. Compared to SOC (n=72, 59%), participants randomized to MyChoices (n=87, 74%; P=.01) were more likely to have received at least 1 HIV test over 6 months of follow-up; those randomized to LYNX also had a higher proportion of testing (n=80, 70%) but it did not reach the a priori threshold for statistical significance (P=.08). Participants in both MyChoices (n=23, 21%) and LYNX (n=21, 20%) arms had higher rates of starting PrEP compared to SOC (n=19, 16%), yet these differences were not statistically significant (P=.52). ConclusionsIn addition to facilitating earlier treatment among those who become aware of their HIV status, given the ubiquity of mobile apps and modest resources required to scale this intervention, a 25% relative increase in HIV testing among young sexual minority men, as seen in this study, could meaningfully reduce HIV incidence in the United States. Trial RegistrationClinicalTrials.gov NCT03965221; https://clinicaltrials.gov/study/NCT03965221https://publichealth.jmir.org/2025/1/e63428 |
| spellingShingle | Katie B Biello Kenneth H Mayer Hyman Scott Pablo K Valente Jonathan Hill-Rorie Susan Buchbinder Lucinda Ackah-Toffey Patrick S Sullivan Lisa Hightow-Weidman Albert Y Liu The Effects of MyChoices and LYNX Mobile Apps on HIV Testing and Pre-Exposure Prophylaxis Use by Young US Sexual Minority Men: Results From a National Randomized Controlled Trial JMIR Public Health and Surveillance |
| title | The Effects of MyChoices and LYNX Mobile Apps on HIV Testing and Pre-Exposure Prophylaxis Use by Young US Sexual Minority Men: Results From a National Randomized Controlled Trial |
| title_full | The Effects of MyChoices and LYNX Mobile Apps on HIV Testing and Pre-Exposure Prophylaxis Use by Young US Sexual Minority Men: Results From a National Randomized Controlled Trial |
| title_fullStr | The Effects of MyChoices and LYNX Mobile Apps on HIV Testing and Pre-Exposure Prophylaxis Use by Young US Sexual Minority Men: Results From a National Randomized Controlled Trial |
| title_full_unstemmed | The Effects of MyChoices and LYNX Mobile Apps on HIV Testing and Pre-Exposure Prophylaxis Use by Young US Sexual Minority Men: Results From a National Randomized Controlled Trial |
| title_short | The Effects of MyChoices and LYNX Mobile Apps on HIV Testing and Pre-Exposure Prophylaxis Use by Young US Sexual Minority Men: Results From a National Randomized Controlled Trial |
| title_sort | effects of mychoices and lynx mobile apps on hiv testing and pre exposure prophylaxis use by young us sexual minority men results from a national randomized controlled trial |
| url | https://publichealth.jmir.org/2025/1/e63428 |
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