A Methamphetamine Treatment Mobile App for Sexual Minority Men: App Utilization, Engagement, and Completion

The culturally responsive cognitive behavioral therapy mobile app, Getting Off, was developed to reduce methamphetamine use and improve sexual health among sexual minority men (SMM).

From May 2021 to May 2023, 226 SMM were enrolled and randomized into 1 of 2 conditions: Immediate Delivery (ID) of the Getting Off app or Delayed Delivery (DD) after a 30-day period. Participants in both conditions received the same app and were given 30 days to complete the 24 in-app sessions. Analyses described in-app session utilization/engagement/completion and identified factors associated with session utilization/engagement/completion.

App utilization was non-normally distributed, with most participants either accessing/completing zero sessions, 1-6 sessions, or all 24 sessions. Participants in the ID condition accessed and completed significantly more sessions than those in the DD condition. Participants reporting higher education, higher annual income, and an STI in the past 12 months utilized and completed more sessions. Adjusting for covariates and randomization group, participants facing unstable housing were less likely to access any sessions (OR = 0.44, p = 0.0393), while those with polysubstance use in the past 12 months were more likely to access at least one session (OR = 4.87, p = 0.0003). Those making higher than $60,000 annual income had higher odds of completing all 24 sessions than those making $15,000 or below (OR = 4.81; p = 0.0148).

Social determinants of health, such as unstable housing, can hinder utilization and engagement in app-based behavioral interventions. Additional health challenges, such as polysubstance use, may enhance engagement in app sessions.