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How an mHealth App Could Increase HIV Testing, Detection


An app for HIV self-testing proved effective in Canada. Can that mHealth app’s success spread?

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An mHealth app might boost HIV self-testing, improving public health, especially in rural and at-risk communities.

A mobile health (mHealth) app could promote the use of self-administered HIV tests among at-risk populations, helping patients execute the tests, interpret results and find medical care, according to a new study.

Investigators from the Research Institute of McGill University Health Centre in Quebec, Canada, found that 99.3 percent of participants who used an app called HIVSmart! underwent self-testing. The app helped direct three people who tested positive for the virus that causes AIDS — or 0.7 percent of participants — to physicians that same day.

What’s more, 98.5 percent of participants considered the HIVSmart! app acceptable, 98.8 percent found it useful and 94 percent said they would recommend it to a friend or partner, according to the study, published in the Journal of Medical Internet Research. Those numbers positively affirmed a critical question that researchers aimed to explore: Would at-risk people use an mHealth app for HIV self-testing?

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“We conclude that the HIVSmart! app-optimized strategy is feasible, accepted and preferred by an educated, urban (men who have sex with men) population of Montreal,” the researchers wrote. “The HIVSmart!-optimized, self-testing strategy could be adapted and contextualized to many at-risk populations within Canada and worldwide, thereby maximizing its public health impact.”

Global public health leaders consider it essential to improve the rates of HIV detection in people who don’t know that they have the virus, the study’s lead author, Nitika Pant Pai, M.D., Ph.D., MPH, noted. An mHealth app like HIVSmart! could put a dent in the number of undiagnosed patients with HIV, opening the door to earlier treatment.

“HIVSmart! plugs all the gaps in the self-testing process,” Pant Pai said. “It works with any approved HIV self-test, facilitates testing and proactively informs the user.”

To gauge the efficacy of the mHealth app, researchers studied 451 men who have sex with men, ages 18 to 73, between July 2016 and February 2017, according to the study. The at-risk group received a self-administered, saliva-based HIV testing kit and a tablet featuring the HIVSmart App!, which they used in an unsupervised setting designed to resemble the home environment.

The mHealth app helped participants perform the test, interpret and store results and obtain care.

Pant Pai said the mHealth app strategy suits people who would rather test themselves in a private setting, an evolution in HIV testing that empowers patients.

But HIVSmart! and similar mHealth apps may prove useful in connecting other popualtions with HIV testing as well.

“An application such as HIVSmart! increases accessibility to testing, especially outside major cities, where it is sometimes harder to get tested because of confidentiality issues,” noted study co-author Réjean Thomas, M.D., founder and head of Clinique Médicale L’Actuel.

The mHealth app is available for smartphone, tablet and web, and Paint Pai and her team developed the tool. They used funding from Grand Challenges Canada to develop the HIVSmart! mHealth app.

Researchers are investigating how the strategy works in other countries and populations. Right now, they’re examining use in South Africa.

HIV self-testing kits have not yet gained approval in Canada, but they are available in the United States.

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