Last data update: May 06, 2024. (Total: 46732 publications since 2009)
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Query Trace: Duarte AP[original query] |
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Development of a mobile app to increase uptake of HIV pre-exposure prophylaxis among latino sexual minority men: A qualitative needs assessment
Cantos VD , Hagen KS , Duarte AP , Escobar C , Batina I , Orozco H , Rodriguez J , Camacho-Gonzalez AF , Siegler AJ . JMIR Form Res 2023 7 e43844 BACKGROUND: Latino sexual minority men (SMM) are disproportionally impacted by HIV. Uptake of pre-exposure prophylaxis (PrEP), an effective biomedical intervention to prevent HIV acquisition, is low in this group compared to White SMM. Mobile technology (mHealth) represents an innovative strategy to increase PrEP uptake among Latino SMM. OBJECTIVE: This paper describes the qualitative process that led to the development of SaludFindr, a comprehensive HIV prevention mobile app that aims to increase PrEP uptake, HIV testing, and condom use by Latino SMM. METHODS: We conducted 13 in-depth interviews with Latino SMM living in metropolitan Atlanta to explore the main barriers and facilitators to PrEP uptake in this group and analyze their overall opinions of potential SaludFindr app functionalities. To explore potential app functions, we used HealthMindr, an existing comprehensive HIV prevention app, as a template and added new proposed features intended to address the specific needs of this community. RESULTS: We identified general PrEP uptake barriers that, although common among non-Latino groups, had added complexities such as the influence of religion and family on stigma. Low perceived PrEP eligibility, intersectional stigma, lack of insurance, cost concerns, and misconceptions about PrEP side effects, were described as general barriers. We also identified Latino-specific barriers that predominantly hinder access to existing services, including a scarcity of PrEP clinics that are prepared to provide culturally-concordant services, limited availability of Spanish-language written information related to PrEP access, distrust of peers as credible sources of information, perceived ineligibility for low-cost services due to undocumented status, fear of immigration authorities, and competing work obligations that prevent PrEP clinic attendance. Healthcare providers represented a trusted source of information and three provider characteristics were identified as PrEP facilitators: familiarity prescribing PrEP, being Latino, and being part of LGBTQIA+ or ally. The proposed app was very well accepted, with particularly high interest in features that facilitate PrEP access, including a tailored list of clinics that meet the community needs and a private platform where app users can gather reliable PrEP information. Spanish language availability and free or low-cost PrEP care represented the two main clinic criteria that would facilitate PrEP uptake. Latino representation in clinic staff and providers, perception of the clinic as a "safe-space" for undocumented patients, and LGBTQIA+ representation were listed as additional criteria. Only 8 our of the 47 clinics listed on PrEP locator.org for the Atlanta area fulfilled at least the two main criteria. CONCLUSIONS: This study provides further evidence of the significant barriers to PrEP uptake that Latino SMM face, exposes the urgent need to increase the number of accessible PrEP-providing clinics for Latino SMM, and proposes an innovative, community-driven, and mobile technology-based tool as a future intervention to overcome some of those barriers. |
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