Putting Prevention in Their Pockets: Developing Mobile Phone-Based HIV Interventions for Black Men Who Have Sex with Men
Publication: AIDS Patient Care and STDs
Volume 27, Issue Number 4
Abstract
Young black men who have sex with men (MSM) bear a disproportionate burden of HIV. Rapid expansion of mobile technologies, including smartphone applications (apps), provides a unique opportunity for outreach and tailored health messaging. We collected electronic daily journals and conducted surveys and focus groups with 22 black MSM (age 18–30) at three sites in North Carolina to inform the development of a mobile phone-based intervention. Qualitative data was analyzed thematically using NVivo. Half of the sample earned under $11,000 annually. All participants owned smartphones and had unlimited texting and many had unlimited data plans. Phones were integral to participants' lives and were a primary means of Internet access. Communication was primarily through text messaging and Internet (on-line chatting, social networking sites) rather than calls. Apps were used daily for entertainment, information, productivity, and social networking. Half of participants used their phones to find sex partners; over half used phones to find health information. For an HIV-related app, participants requested user-friendly content about test site locators, sexually transmitted diseases, symptom evaluation, drug and alcohol risk, safe sex, sexuality and relationships, gay-friendly health providers, and connection to other gay/HIV-positive men. For young black MSM in this qualitative study, mobile technologies were a widely used, acceptable means for HIV intervention. Future research is needed to measure patterns and preferences of mobile technology use among broader samples.
Get full access to this article
View all available purchase options and get full access to this article.
References
1.
US Centers for Disease Control and Prevention. Trends in HIV/AIDS Diagnoses Among Men Who Have Sex with Men—33 States, 2001–2006MMWR200857681-686. 1. US Centers for Disease Control and Prevention. Trends in HIV/AIDS Diagnoses Among Men Who Have Sex with Men—33 States, 2001–2006. MMWR 2008;57:681–686.
2.
US Centers for Disease Control and Prevention. Subpopulation Estimates from the HIV Incidence Surveillance System—United States, 2006MMWR200857985-989. 2. US Centers for Disease Control and Prevention. Subpopulation Estimates from the HIV Incidence Surveillance System—United States, 2006. MMWR 2008;57:985–989.
3.
Millett GAPeterson JLFlores SA et al. Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: A meta-analysisLancet2012380341-348. 3. Millett GA, Peterson JL, Flores SA, et al. Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: A meta-analysis. Lancet 2012;380:341–348.
4.
Su JRBeltrami JFZaidi AAWeinstock HS. Primary and secondary syphilis among black and Hispanic men who have sex with men: Case report data from 27 StatesAnn Internal Med2011155145-151. 4. Su JR, Beltrami JF, Zaidi AA, Weinstock HS. Primary and secondary syphilis among black and Hispanic men who have sex with men: Case report data from 27 States. Ann Internal Med 2011;155:145–151.
5.
US Centers for Disease Control and Prevention. Prevalence and awareness of HIV infection among men who have sex with men—21 cities, United States, 2008MMWR2010591201-1207. 5. US Centers for Disease Control and Prevention. Prevalence and awareness of HIV infection among men who have sex with men—21 cities, United States, 2008. MMWR 2010;59:1201–1207.
6.
US Centers for Disease Control and Prevention2012. HIV in the United States: At A GlanceJanuary42013http://www.cdc.gov/hiv/resources/factsheets/us.htmhttp://www.webcitation.org/6BL7ZHdGx. 6. US Centers for Disease Control and Prevention. 2012. HIV in the United States: At A Glance. Accessed January 4, 2013 at: http://www.cdc.gov/hiv/resources/factsheets/us.htm. Archived at: http://www.webcitation.org/6BL7ZHdGx.
7.
Oster AMWiegand RESionean C et al. Understanding disparities in HIV infection between black and white MSM in the United StatesAIDS (London, England)2011251103-1112. 7. Oster AM, Wiegand RE, Sionean C, et al. Understanding disparities in HIV infection between black and white MSM in the United States. AIDS (London, England) 2011;25:1103–1112.
8.
Tinsley MJXavier J. Outreach, care, and prevention to engage HIV seropositive young men of color who have sex with men: A special project of national significance program initiativeAIDS Patient Care STDs201125S1-2. 8. Tinsley MJ, Xavier J. Outreach, care, and prevention to engage HIV seropositive young men of color who have sex with men: A special project of national significance program initiative. AIDS Patient Care STDs 2011;25:S1–2.
9.
Phillips G 2ndWohl AXavier JJones KHidalgo J. Epidemiologic data on young men of color who have sex with menAIDS Patient Care STDs201125S3-8. 9. Phillips G 2nd, Wohl A, Xavier J, Jones K, Hidalgo J. Epidemiologic data on young men of color who have sex with men. AIDS Patient Care STDs 2011;25:S3–8.
10.
Outlaw AYPhillips G 2ndHightow-Weidman LB et al. Age of MSM sexual debut and risk factors: Results from a multisite study of racial/ethnic minority YMSM living with HIVAIDS Patient Care STDs201125S23-29. 10. Outlaw AY, Phillips G, 2nd, Hightow-Weidman LB, et al. Age of MSM sexual debut and risk factors: Results from a multisite study of racial/ethnic minority YMSM living with HIV. AIDS Patient Care STDs 2011;25:S23–29.
11.
The White House Office of National AIDS Policy. National HIV/AIDS Strategy for the United StatesWashington, DCJuly132010January42013http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdfhttp://www.webcitation.org/69kDUucak. 11. The White House Office of National AIDS Policy. National HIV/AIDS Strategy for the United States. Washington, DC. Released July 13, 2010. Accessed January 4, 2013 at: http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf. Archived at: http://www.webcitation.org/69kDUucak.
12.
Lim MSHocking JSHellard MEAitken CK. SMS STI: A review of the uses of mobile phone text messaging in sexual healthInt J STD AIDS200819287-290. 12. Lim MS, Hocking JS, Hellard ME, Aitken CK. SMS STI: A review of the uses of mobile phone text messaging in sexual health. Int J STD AIDS 2008;19:287–290.
13.
Mukund Bahadur KCMurray PJ. Cell phone short messaging service (SMS) for HIV/AIDS in South Africa: A literature reviewStud Health Technol Inform2010160530-534. 13. Mukund Bahadur KC, Murray PJ. Cell phone short messaging service (SMS) for HIV/AIDS in South Africa: A literature review. Stud Health Technol Inform 2010;160:530–534.
14.
Ybarra MLBull SS. Current trends in Internet- and cell phone-based HIV prevention and intervention programsCurr HIV/AIDS Rep20074201-207. 14. Ybarra ML, Bull SS. Current trends in Internet- and cell phone-based HIV prevention and intervention programs. Curr HIV/AIDS Rep 2007;4:201–207.
15.
Cornelius JBCato MLawrence JSBoyer CBLightfoot M. Development and pretesting multimedia HIV-prevention text messages for mobile cell phone deliveryJ Assoc Nurses AIDS Care201122407-413. 15. Cornelius JB, Cato M, Lawrence JS, Boyer CB, Lightfoot M. Development and pretesting multimedia HIV-prevention text messages for mobile cell phone delivery. J Assoc Nurses AIDS Care 2011;22:407–413.
16.
Lim EJHaar JMorgan J. Can text messaging results reduce time to treatment of Chlamydia trachomatis?Sex Trans Infect200884563-564. 16. Lim EJ, Haar J, Morgan J. Can text messaging results reduce time to treatment of Chlamydia trachomatis? Sex Trans Infect 2008;84:563–564.
17.
Cornelius JBCato MGToth JLBard PMMoore MWWhite A. Following the trail of an HIV-prevention Web site enhanced for mobile cell phone text messaging deliveryJ Assoc Nurses AIDS Care201223255-259. 17. Cornelius JB, Cato MG, Toth JL, Bard PM, Moore MW, White A. Following the trail of an HIV-prevention Web site enhanced for mobile cell phone text messaging delivery. J Assoc Nurses AIDS Care 2012;23:255–259.
18.
Lester RTRitvo PMills EJ et al. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): A randomised trialLancet20103761838-1845. 18. Lester RT, Ritvo P, Mills EJ, et al. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): A randomised trial. Lancet 2010;376:1838–1845.
19.
Hardy HKumar VDoros G et al. Randomized controlled trial of a personalized cellular phone reminder system to enhance adherence to antiretroviral therapyAIDS Patient Care STDs201125153-161. 19. Hardy H, Kumar V, Doros G, et al. Randomized controlled trial of a personalized cellular phone reminder system to enhance adherence to antiretroviral therapy. AIDS Patient Care STDs 2011;25:153–161.
20.
Horvath TAzman HKennedy GERutherford GW. Mobile phone text messaging for promoting adherence to antiretroviral therapy in patients with HIV infectionCochrane Database Syst Rev20123CD009756. 20. Horvath T, Azman H, Kennedy GE, Rutherford GW. Mobile phone text messaging for promoting adherence to antiretroviral therapy in patients with HIV infection. Cochrane Database Syst Rev 2012;3:CD009756.
21.
da Costa TBarbosa BGomes e Costa D et al. Results of a randomized controlled trial to assess the effects of a mobile SMS-based intervention on treatment adherence in HIV/AIDS-infected Brazilian women and impressions and satisfaction with respect to incoming messagesInt J Med Inform201281257-269. 21. da Costa T, Barbosa B, Gomes e Costa D, et al. Results of a randomized controlled trial to assess the effects of a mobile SMS-based intervention on treatment adherence in HIV/AIDS-infected Brazilian women and impressions and satisfaction with respect to incoming messages. Int J Med Inform 2012;81:257–269.
22.
Pop-Eleches CThirumurthy HHabyarimana JP et al. Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: A randomized controlled trial of text message remindersAIDS201125825-834. 22. Pop-Eleches C, Thirumurthy H, Habyarimana JP, et al. Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: A randomized controlled trial of text message reminders. AIDS 2011;25:825–834.
23.
Dowshen NKuhns LJohnson AHoloyda BGarofalo R. Improving adherence to antiretroviral therapy for youth living with HIV/AIDS: A pilot study using personalized, interactive, daily test message remindersJ Med Internet Res201214e51. 23. Dowshen N, Kuhns L, Johnson A, Holoyda B, Garofalo R. Improving adherence to antiretroviral therapy for youth living with HIV/AIDS: A pilot study using personalized, interactive, daily test message reminders. J Med Internet Res 2012;14:e51.
24.
Swendeman DRotheram-Borus MJ. Innovation in sexually transmitted disease and HIV prevention: Internet and mobile phone delivery vehicles for global diffusionCurr Opin Psychiatry201023139-144. 24. Swendeman D, Rotheram-Borus MJ. Innovation in sexually transmitted disease and HIV prevention: Internet and mobile phone delivery vehicles for global diffusion. Curr Opin Psychiatry 2010;23:139–144.
25.
Juzang IFortune TBlack SWright EBull S. A pilot programme using mobile phones for HIV preventionJ Telemed Telecare201117150-153. 25. Juzang I, Fortune T, Black S, Wright E, Bull S. A pilot programme using mobile phones for HIV prevention. J Telemed Telecare 2011;17:150–153.
26.
Hightow-Weidman LBPike EFowler B et al. HealthMpowerment.org: Feasibility and acceptability of delivering an Internet intervention to young Black men who have sex with menAIDS Care201224910-920. 26. Hightow-Weidman LB, Pike E, Fowler B, et al. HealthMpowerment.org: Feasibility and acceptability of delivering an Internet intervention to young Black men who have sex with men. AIDS Care 2012;24:910–920.
27.
Ramanathan NSwendeman DComulada WSEstrin DRotheram-Borus MJ. Identifying preferences for mobile health applications for self-monitoring and self-management: Focus group findings from HIV-positive persons and young mothersInt J Med Inform201382e38-e46. 27. Ramanathan N, Swendeman D, Comulada WS, Estrin D, Rotheram-Borus MJ. Identifying preferences for mobile health applications for self-monitoring and self-management: Focus group findings from HIV-positive persons and young mothers. Int J Med Inform 2013; 82:e38–e46.
28.
Pew Internet and American Life Project. “Two-thirds of young adults and those with higher income are smartphone owners.”Pew Research CenterSeptember112012January42013http://pewInternet.org/∼/media//Files/Reports/2012/PIP_Smartphones_Sept12%209%2010%2012.pdfhttp://www.webcitation.org/6BL7SWcmP. 28. Pew Internet and American Life Project. “Two-thirds of young adults and those with higher income are smartphone owners.” Pew Research Center, September 11, 2012. Accessed January 4, 2013 at: http://pewInternet.org/∼/media//Files/Reports/2012/PIP_Smartphones_Sept12%209%2010%2012.pdf. Archived at: http://www.webcitation.org/6BL7SWcmP.
29.
Community Marketing Inc. “2012 LGBT Community Survey.”2012January42013http://www.communitymarketinginc.com/documents/CMI_6th_LGBT_Community_Survey_USv1.pdfhttp://www.webcitation.org/6BJhmVzwt. 29. Community Marketing Inc. “2012 LGBT Community Survey.” 2012. Accessed January 4, 2013 at: http://www.communitymarketinginc.com/documents/CMI_6th_LGBT_Community_Survey_USv1.pdf. Archived at: http://www.webcitation.org/6BJhmVzwt.
30.
Community Marketing Inc. “16th Annual Gay & Lesbian Tourism Report: Exploring tourism and hospitality opportunities in the gay and lesbian marketplace 2011–2012.”2012January42013http://www.communitymarketinginc.com/documents/temp/CMI_16thLGBTTourismStudy.pdfhttp://www.webcitation.org/6CCB3xyJv. 30. Community Marketing Inc. “16th Annual Gay & Lesbian Tourism Report: Exploring tourism and hospitality opportunities in the gay and lesbian marketplace 2011–2012.” 2012. Accessed January 4, 2013 at: http://www.communitymarketinginc.com/documents/temp/CMI_16thLGBTTourismStudy.pdf. Archived at: http://www.webcitation.org/6CCB3xyJv.
31.
Zickuhr KSmith AApril132012. Digital Differences. Pew Internet and American Life ProjectJanuary42013http://pewInternet.org/∼/media//Files/Reports/2012/PIP_Digital_differences_041312.pdfhttp://www.webcitation.org/6BL7HMIo4. 31. Zickuhr K, Smith A. April 13, 2012. Digital Differences. Pew Internet and American Life Project. Accessed January 4, 2013 at: http://pewInternet.org/∼/media//Files/Reports/2012/PIP_Digital_differences_041312.pdf. Archived at: http://www.webcitation.org/6BL7HMIo4.
32.
Hightow-Weidman LBFowler BKibe J et al. HealthMpowerment.org: Development of a theory-based HIV/STI website for young black MSMAIDS Edu Prevent2011231-12. 32. Hightow-Weidman LB, Fowler B, Kibe J, et al. HealthMpowerment.org: Development of a theory-based HIV/STI website for young black MSM. AIDS Edu Prevent 2011;23:1–12.
33.
Lefebvre RFlora J. Social Marketing and Public Health InterventionHealth Edu Quart198815299-315. 33. Lefebvre R, Flora J. Social Marketing and Public Health Intervention. Health Edu Quart 1988;15:299–315.
34.
Kotler PZaltman G. Social marketing: An approach to planned social changeJ Marketing1971353-12. 34. Kotler P, Zaltman G. Social marketing: An approach to planned social change. J Marketing 1971;35:3–12.
35.
Hsieh HFShannon SE. Three approaches to qualitative content analysisQual Health Res2005151277-1288. 35. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res 2005;15:1277–1288.
36.
Morgan DL. Focus Groups as Qualitative ResearchSecondQualitative Research MethodsSeries 16Sage PublicationsThousand Oaks, California199634-44. 36. Morgan DL. Focus Groups as Qualitative Research Second Edition. Qualitative Research Methods, Series 16. Sage Publications, Thousand Oaks, California, 1996, pp. 34–44.
37.
Smith A. 35% of American adults own a smartphoneWashington, DCPew Internet and American Life Project2011February82013http://pewInternet.org/Reports/2011/Smartphones/Summary.aspx. 37. Smith A. 35% of American adults own a smartphone. Washington, DC: Pew Internet and American Life Project; 2011. Accessed February 8, 2013 at: http://pewInternet.org/Reports/2011/Smartphones/Summary.aspx.
38.
Wise JOperario D. Use of electronic reminder devices to improve adherence to antiretroviral therapy: a systematic reviewAIDS Patient Care STDs200822495-504. 38. Wise J, Operario D. Use of electronic reminder devices to improve adherence to antiretroviral therapy: a systematic review. AIDS Patient Care STDs 2008;22:495–504.
39.
Marcotte EResponsive Web DesignA Book Appart LLC. Happy Cog HostingISBN 978-0-9844425-7-7. 39. Marcotte E. Responsive Web Design. A Book Appart LLC. Happy Cog Hosting. ISBN 978-0-9844425-7-7.
40.
George SPhillips RMcDavitt BAdams WMutchler MG. The Cellular Generation and a New Risk Environment: Implications for Texting-Based Sexual Health Promotion Interventions among Minority Young Men Who Have Sex with MenAMIA Annual Symposium proceedings, AMIA Symposium2012247-256. 40. George S, Phillips R, McDavitt B, Adams W, Mutchler MG. The Cellular Generation and a New Risk Environment: Implications for Texting-Based Sexual Health Promotion Interventions among Minority Young Men Who Have Sex with Men. AMIA Annual Symposium proceedings, AMIA Symposium 2012:247–256.
41.
Coughlin SS. Recall bias in epidemiologic studiesJ Clin Epidemiol19904387-91. 41. Coughlin SS. Recall bias in epidemiologic studies. J Clin Epidemiol1990;43:87–91.
42.
Shiffman S. How many cigarettes did you smoke? Assessing cigarette consumption by global report, time-line follow-back, and ecological momentary assessmentHealth Psychol200928519-526. 42. Shiffman S. How many cigarettes did you smoke? Assessing cigarette consumption by global report, time-line follow-back, and ecological momentary assessment. Health Psychol 2009;28:519–526.
43.
Muessig KEPike ELeGrand SHightow-Weidman LB. A systematic review of mobile phone applications for HIV care and preventionJ Med Internet Res201315e1. 43. Muessig KE, Pike E, LeGrand S, Hightow-Weidman LB. A systematic review of mobile phone applications for HIV care and prevention. J Med Internet Res 2013;15:e1.
44.
Farago PFlurry Analytics Flurry BlogOctober152009Global App Retention: A Tale of Two EconomiesJanuary42013http://blog.flurry.com/bid/27138/Global-App-Retention-A-Tale-of-Two-Economieshttp://www.webcitation.org/69axtK59W. 44. Farago P, Flurry Analytics Flurry Blog, posted October 15, 2009. Global App Retention: A Tale of Two Economies. Accessed January 4, 2013 at: http://blog.flurry.com/bid/27138/Global-App-Retention-A-Tale-of-Two-Economies. Archived at: http://www.webcitation.org/69axtK59W.
45.
Hurt CBBeagle SLeone PA et al. Investigating a sexual network of black men who have sex with men: Implications for transmission and prevention of HIV infection in the United StatesJ Acquir Immune Defic Syndr201261515-521. 45. Hurt CB, Beagle S, Leone PA, et al. Investigating a sexual network of black men who have sex with men: Implications for transmission and prevention of HIV infection in the United States. J Acquir Immune Defic Syndr 2012;61:515–521.
46.
Lewis MAUhrig JDBann CM et al. Tailored text messaging intervention for HIV adherence: A proof-of-concept studyHealth Psychol201332248-253. 46. Lewis MA, Uhrig JD, Bann CM, et al. Tailored text messaging intervention for HIV adherence: A proof-of-concept study. Health Psychol 2013;32:248–253.
Information & Authors
Information
Published In
Copyright
Copyright 2013, Mary Ann Liebert, Inc.
History
Published online: 8 April 2013
Published in print: April 2013
Topics
Authors
Author Disclosure Statement
No competing financial interests exist.
Metrics & Citations
Metrics
Citations
Export Citation
Export citation
Select the format you want to export the citations of this publication.
View Options
Get Access
Access content
To read the fulltext, please use one of the options below to sign in or purchase access.⚠ Society Access
If you are a member of a society that has access to this content please log in via your society website and then return to this publication.