DOT Diary: Developing a Novel Mobile App Using Artificial Intelligence and an Electronic Sexual Diary to Measure and Support PrEP Adherence Among Young Men Who Have Sex with Men

Albert Y Liu, Nicole D Laborde, Kenneth Coleman, Eric Vittinghoff, Rafael Gonzalez, Gretchen Wilde, Annie L Thorne, Ed Ikeguchi, Laura Shafner, Lauren Sunshine, Ariane van der Straten, Aaron J Siegler, Susan Buchbinder, Albert Y Liu, Nicole D Laborde, Kenneth Coleman, Eric Vittinghoff, Rafael Gonzalez, Gretchen Wilde, Annie L Thorne, Ed Ikeguchi, Laura Shafner, Lauren Sunshine, Ariane van der Straten, Aaron J Siegler, Susan Buchbinder

Abstract

Young men who have sex with men (YMSM) are highly vulnerable to HIV. While pre-exposure prophylaxis (PrEP) has demonstrated effectiveness, adherence has been low among YMSM and difficult to measure accurately. In collaboration with a healthcare company, we configured an automated directly-observed therapy (aDOT) platform for monitoring and supporting PrEP use. Based on interest expressed in focus groups among 54 YMSM, we combined aDOT with an electronic sexual diary to provide feedback on level of protection during sex and to motivate app use. In an 8-week optimization pilot with 20 YMSM in San Francisco and Atlanta, the app was found to be highly acceptable, with median System Usability Scale scores in the "excellent" range (80/100). App use was high, with median PrEP adherence of 91% based on aDOT-confirmed dosing. Most (84%) participants reported the app helped with taking PrEP. These promising findings support further evaluation of DOT Diary in future effectiveness studies.

Keywords: Adherence; Artificial intelligence; HIV; Mobile health; Pre-exposure prophylaxis.

Figures

Figure 1:
Figure 1:
Screenshots of DOT Diary App
Figure 2:
Figure 2:
Helpfulness of different app components
Figure 3:
Figure 3:
Data Visualizations Added to New Version of DOT Diary App

Source: PubMed

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