An Adapted Intervention Mapping Approach to Scaling Digital HIV Care Through Single-Session Design

Digital health interventions (DHIs) for HIV prevention have demonstrated feasibility, acceptability, and, to a lesser extent, efficacy, but few have achieved widespread dissemination. We used intervention mapping and single-session design principles to adapt Keep It Up! (KIU!), a CDC-designated best-evidence HIV prevention program originally delivered over 6 months, into a single-session intervention, Keep It Brief! A 13-member expert and community advisory board guided six adaptation steps, prioritizing behavioral outcomes, objectives, and KIU!'s core theoretical determinants. The resulting intervention includes a universal HIV module, a tailored PrEP module based on users' PrEP experience, and a relationship module for participants who are single, monogamous, or in open/polyamorous relationships. Usability testing with 15 end users demonstrated high acceptability, engagement, and usability. Findings suggest that adapting multisession DHIs into single-session formats can preserve core intervention mechanisms while improving reach to populations and settings where multisession delivery is infeasible. We provide recommendations for future adaptation.