Adding a Prevention Intervention to an Established App: The Blued+ HIV Prevention Pilot Study in Beijing and Chengdu,
Aaron J Siegler1, Guodong Mi2, Fei Yu2
1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Introduction:
HIV incidence among men who have sex with men (MSM) in China remains high, and the use of effective tools such as pre-exposure prophylaxis (PrEP) is suboptimal. Smartphone app interventions are promising yet rarely move beyond the research sphere. Rather than inventing stand-alone apps that rarely come to scale, integrating health interventions into existing multifunction apps would be a paradigm shift for research and practice.
Methods:
We conducted a prospective, single-arm pilot study of an intervention platform built directly into Blued, a geosocial networking (dating) app for MSM with more than 6 million users in China. The intervention provided telePrEP care (including in-app clinician services, reimbursed laboratory testing and mailed PrEP prescriptions), health messaging, and an order platform for home HIV tests and condoms. The pilot study, in Beijing and Chengdu, compared the intervention to contemporary repeated cross-sectional comparison surveys. Primary outcomes were benchmarks for feasibility (≥30% home HIV test orders and ≥20% HIV PrEP prescriptions) and acceptability (≥71 System Usability Scale [SUS] score). Preliminary efficacy assessment compared changes in the intervention group to the repeated comparison groups with generalized estimating equations (GEE) models.
Results:
From July 2022 to December 2024, 423 people started the pilot intervention, 400 (95%) were retained at 6 months and 399 (94%) at 12 months. All primary outcomes at 12 months were significantly higher than prespecified benchmarks: 87% (366/423) ordered HIV tests, 42% (176/423) received PrEP prescriptions, and the mean SUS score was 73/100. In GEE models adjusting for group characteristics and the secular trend of the comparison groups, between baseline and 12 months, the intervention group had an absolute increase in PrEP use of 20% (95% CI: 13%-27%) and in HIV testing of 7% (95% CI: 1%-13%). There was no difference in condom use.
Conclusions:
In this study, we found that it is feasible and acceptable to incorporate HIV prevention interventions into existing apps. This model, with encouraging preliminary efficacy data, represents a new public-private model for improving uptake of evidence-based prevention interventions. Future research should test this model in a randomized clinical trial.