Smartphone-Based Contingency Management Intervention to Improve Pre-Exposure Prophylaxis Adherence: Pilot Trial.

Area of Science:

• Public Health
• Digital Health
• HIV Prevention

Background:

• Pre-exposure prophylaxis (PrEP) is crucial for HIV prevention, but its efficacy depends on consistent adherence.
• Adherence rates to PrEP vary significantly among individuals.

Purpose of the Study:

• To develop and pilot-test mSMART, a smartphone-based intervention designed to enhance PrEP adherence.
• mSMART incorporates contingency management with monetary incentives, medication reminders, education, and behavioral strategies.

Main Methods:

• A 4-week, open-label, phase I trial was conducted.
• The study included 10 young men who have sex with men currently on PrEP.

Main Results:

• Biomarkers indicated 90% had acceptable baseline PrEP adherence.
• Adherence scores improved in 30% of participants, with no worsening.
• Participants reported 91% adherence via the app and high satisfaction with mSMART.

Conclusions:

• mSMART is the first intervention to use contingency management for PrEP adherence.
• The study demonstrates mSMART's feasibility and acceptability for widespread dissemination.
• Further efficacy trials are warranted to confirm these findings.