{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:00:35Z","timestamp":1782842435466,"version":"3.54.5"},"reference-count":55,"publisher":"JMIR Publications Inc.","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"\n Background<\/jats:title>\n Widespread smartphone use provides opportunities for mobile health HIV prevention strategies among at-risk populations.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aims to investigate engagement in a theory-based (information\u2013motivation\u2013behavioral skills model) mobile phone app developed to support HIV pre-exposure prophylaxis (PrEP) adherence among Thai young men who have sex with men (YMSM) and young transgender women (YTGW) in Bangkok, Thailand.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A randomized controlled trial was conducted among HIV-negative YMSM and YTGW aged 15-19 years initiating daily oral PrEP. Participants were randomized to receive either youth-friendly PrEP services (YFS) for 6 months, including monthly contact with site staff (clinic visits or telephone follow-up) and staff consultation access, or YFS plus use of a PrEP adherence support app (YFS+APP). The target population focus group discussion findings and the information\u2013motivation\u2013behavioral skills model informed app development. App features were based on the 3Rs\u2014risk assessment of self-HIV acquisition risk, reminders to take PrEP, and rewards as redeemable points. Dried blood spots quantifying of tenofovir diphosphate were collected at months 3 and 6 to assess PrEP adherence. Tenofovir diphosphate \u2265350-699 fmol\/punch was classified as fair adherence and \u2265700 fmol\/punch as good adherence. Data analysis on app use paradata and exit interviews were conducted on the YFS+APP arm after 6 months of follow-up.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Between March 2018 and June 2019, 200 participants with a median age of 18 (IQR 17-19) years were enrolled. Overall, 74% (148\/200) were YMSM; 87% (87\/100) of participants who received YFS+APP logged in to the app and performed weekly HIV acquisition risk assessments (log-in and risk assessment [LRA]). The median duration between the first and last log-in was 3.5 (IQR 1.6-5.6) months, with a median frequency of 6 LRAs (IQR 2-10). Moreover, 22% (22\/100) of the participants in the YFS+APP arm were frequent users (LRA\u226510) during the 6-month follow-up period. YMSM were 9.3 (95% CI 1.2-74.3) times more likely to be frequent app users than YTGW (P=.04). Frequent app users had higher proportions (12%-16%) of PrEP adherence at both months 3 and 6 compared with infrequent users (LRA<10) and the YFS arm, although this did not reach statistical significance. Of the 100 participants in the YFS+APP arm, 23 (23%) were interviewed. The risk assessment function is perceived as the most useful app feature. Further aesthetic adaptations and a more comprehensive rewards system were suggested by the interviewees.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Higher rates of PrEP adherence among frequent app users were observed; however, this was not statistically significant. A short app use duration of 3 months suggests that they may be useful in establishing habits in taking daily PrEP, but not long-term adherence. Further studies on the specific mechanisms of mobile phone apps that influence health behaviors are needed.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n ClinicalTrials.gov NCT03778892; https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03778892<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/25561","type":"journal-article","created":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T11:00:57Z","timestamp":1650538857000},"page":"e25561","source":"Crossref","is-referenced-by-count":26,"title":["A Mobile Phone App to Support Adherence to Daily HIV Pre-exposure Prophylaxis Engagement Among Young Men Who Have Sex With Men and Transgender Women Aged 15 to 19 Years in Thailand: Pilot Randomized Controlled Trial"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0189-4125","authenticated-orcid":false,"given":"Surinda","family":"Kawichai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3440-732X","authenticated-orcid":false,"given":"Wipaporn Natalie","family":"Songtaweesin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4245-0419","authenticated-orcid":false,"given":"Prissana","family":"Wongharn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0036-3165","authenticated-orcid":false,"given":"Nittaya","family":"Phanuphak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8106-0974","authenticated-orcid":false,"given":"Tim R","family":"Cressey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9840-2168","authenticated-orcid":false,"given":"Juthamanee","family":"Moonwong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5731-6968","authenticated-orcid":false,"given":"Anuchit","family":"Vasinonta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4044-0951","authenticated-orcid":false,"given":"Chutima","family":"Saisaengjan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6053-9436","authenticated-orcid":false,"given":"Tanat","family":"Chinbunchorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0019-2183","authenticated-orcid":false,"given":"Thanyawee","family":"Puthanakit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2022,4,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-019-02626-1"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1923-2"},{"key":"ref3","year":"2011","journal-title":"mHealth: New Horizons for Health Through Mobile Technologies: Second Global Survey on eHealth"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.1430"},{"key":"ref5","unstructured":"Topics: key populationsUNAIDS20202022-01-07https:\/\/www.unaids.org\/en\/topic\/key-populations"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052669"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32835c546e"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000176"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1963-7"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181c2fc86"},{"key":"ref11","unstructured":"HIV Surveillance Report, 2018 (Updated)Centers for Disease Control and Prevention20202022-01-17https:\/\/www.cdc.gov\/hiv\/library\/reports\/hiv-surveillance.html"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2018.1492697"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-016-1485-8"},{"key":"ref14","unstructured":"Policy brief: pre-exposure prophylaxis (PrEP): WHO expands recommendation on oral pre-exposure prophylaxis of HIV infection (PrEP). 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