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Using the UTAUT model to understand HIV-negative MSM's intention to use a proposed HIV prevention mHealth management
Jingchun He1,2, Hong Chen1, Wei He2
1School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China.
Background:
Men who have sex with men (MSM) are key to China's HIV prevention. In China, the proportion of HIV transmission attributed to homosexual sexual behavior increased from 9.1% in 2009 to 23.3% in 2020, highlighting the growing importance of HIV prevention among MSM. Mobile health (mHealth) interventions offer distinct advantages: lowering barriers to service access, mitigating social stigma, and improving accessibility of HIV-related interventions. However, evidence remains limited regarding HIV-negative MSM's pre-implementation intention to use HIV prevention mHealth management systems.
Objective:
Guided by the Unified Theory of Acceptance and Use of Technology (UTAUT), this study examined factors associated with HIV-negative MSM's behavioral intention to use a proposed HIV prevention mHealth management system.
Methods:
A cross-sectional survey was conducted in Chongqing, China, from 2024 to 2025. A total of 469 HIV-negative MSM were recruited through NGO and VCT-related channels. Participants evaluated a proposed system concept introduced through a standardized description; the system had not yet been deployed or user-tested. Structured questionnaires assessed demographic characteristics and UTAUT constructs. Descriptive analyses were performed using R, and structural equation modeling was conducted using Mplus.
Results:
The final SEM showed acceptable model fit (χ2/df = 3.798, RMSEA = 0.076, CFI = 0.959, SRMR = 0.047). Performance expectancy (β = 0.431, P < 0.001) and social influence (β = 0.412, P < 0.001) were positively associated with behavioral intention, while effort expectancy (β = 0.039, P = 0.700) and facilitating conditions (β = 0.157, P = 0.106) were not.
Conclusions:
Pre-implementation intention to use the proposed HIV prevention mHealth management system was mainly associated with perceived system effectiveness and social influence. Future HIV-related mHealth interventions should emphasize system effectiveness and leverage peer/community support to enhance adoption.
