title: Building a Mobile HIV Prevention App for Men Who Have Sex With Men: An Iterative and Community-Driven Process.
abstract: BACKGROUND
  Gay, bisexual, and other men who have sex with men (MSM) account for a disproportionate burden of new HIV infections in the United States. Mobile technology presents an opportunity for innovative interventions for HIV prevention. Some HIV prevention apps currently exist; however, it is challenging to encourage users to download these apps and use them regularly. An iterative research process that centers on the community's needs and preferences may increase the uptake, adherence, and ultimate effectiveness of mobile apps for HIV prevention.
  
  
  OBJECTIVE
  The aim of this paper is to provide a case study to illustrate how an iterative community approach to a mobile HIV prevention app can lead to changes in app content to appropriately address the needs and the desires of the target community.
  
  
  METHODS
  In this three-phase study, we conducted focus group discussions (FGDs) with MSM and HIV testing counselors in Atlanta, Seattle, and US rural regions to learn preferences for building a mobile HIV prevention app. We used data from these groups to build a beta version of the app and theater tested it in additional FGDs. A thematic data analysis examined how this approach addressed preferences and concerns expressed by the participants.
  
  
  RESULTS
  There was an increased willingness to use the app during theater testing than during the first phase of FGDs. Many concerns that were identified in phase one (eg, disagreements about reminders for HIV testing, concerns about app privacy) were considered in building the beta version. Participants perceived these features as strengths during theater testing. However, some disagreements were still present, especially regarding the tone and language of the app.
  
  
  CONCLUSIONS
  These findings highlight the benefits of using an interactive and community-driven process to collect data on app preferences when building a mobile HIV prevention app. Through this process, we learned how to be inclusive of the larger MSM population without marginalizing some app users. Though some issues in phase one were able to be addressed, disagreements still occurred in theater testing. If the app is going to address a large and diverse risk group, we cannot include niche functionality that may offend some of the target population.
authors.affiliation: School of Nursing Department of Health Behavior and Biological Sciences and the Center for Sexuality and Health Disparities University of Michigan Ann Arbor, MI United States.
authors.forename: Tamar
authors.identifier: 0000-0003-3998-2913
authors.initials: T
authors.lastname: Goldenberg
authors.affiliation: Department of Medicine Division of Allergy and Infectious Diseases University of Washington Seattle, WA United States.
authors.forename: Sarah J
authors.identifier: 0000-0001-7690-7002
authors.initials: SJ
authors.lastname: McDougal
authors.affiliation: Rollins School of Public Health Department of Epidemiology Emory University Atlanta, GA United States.
authors.forename: Patrick S
authors.identifier: 0000-0002-7728-0587
authors.initials: PS
authors.lastname: Sullivan
authors.affiliation: Department of Medicine Division of Allergy and Infectious Diseases University of Washington Seattle, WA United States.
authors.forename: Joanne D
authors.identifier: 0000-0001-8064-3011
authors.initials: JD
authors.lastname: Stekler
authors.affiliation: School of Nursing Department of Health Behavior and Biological Sciences and the Center for Sexuality and Health Disparities University of Michigan Ann Arbor, MI United States.
authors.forename: Rob
authors.identifier: 0000-0001-6034-2019
authors.initials: R
authors.lastname: Stephenson
keywords: AIDS; HIV; MSM; community; mobile app; prevention