The U.S. will spend millions of dollars to implement and evaluate if an interactive text messaging program used by the government is effective in helping transgender women of color and young men who have sex with men (YMSM) take readily available measures to protect against human immunodeficiency virus (HIV), a sexually transmitted infection that attacks the body’s immune system. The mobile health intervention is known as PrEPmate, and it is supposed to increase HIV pre-exposure prophylaxis (PrEP) adherence and retention within the demographic by delivering “youth-tailored” text messages with interactive content, reminders for clinic appointments and prescriptions as well as a dashboard that may be integrated into electronic medical records.
This week the Centers for Disease Control (CDC) announced that it is doling out $3 million to nonprofits, local governments, school districts and public housing authorities to facilitate implementation of the PrEPmate intervention at three clinical sites in the nation’s southern region, where there is increased HIV disease burden. Grant recipients will monitor and evaluate how the mobile health intervention is integrated into the delivery of clinical services to improve prophylaxis adherence and retention in care, the agency writes in its announcement. The goal is to increase medication adherence and retention among patients and boost adaptability and sustainability among clinical providers. “A secondary outcome will be the identification of best practices and lessons learned for implementing PrEPmate in clinics serving YMSM and transgender women of color,” the CDC writes.
The agency, which operates under the Department of Health and Human Services (HHS), has already determined that PrEPmate is an evidence-based tool for the intervention of HIV prevention among YMSM, which means the recent multi-million-dollar allocation is likely going to focus more on transgender women of color. A 2016 study focusing on Latino, black and white “HIV-negative young men who have sex with men (YMSM) at risk for HIV acquisition” found that preventative care and medication adherence/persistence was greater among those using the mobile health program and a significantly larger proportion of visits to healthcare providers were completed by those men as well. PrEPmate users received weekly check in messages and daily pill-taking reminders during the 36-week study as well as videos explaining how prophylaxis works in the body.
A more recent study published less than a year ago, found that the use of measures to prevent HIV improved when using a mobile health intervention, though the program was “culturally tailored” by researchers for Spanish-speaking men who have sex with men and transgender women who spoke either English or Spanish. “A growing number of mobile health (mHealth) technologies are being developed to support HIV preexposure prophylaxis (PrEP) adherence and persistence; however, most tools have focused on men who have sex with men (MSM), and few are available in Spanish,” researchers of that study wrote. “To maximize the potential impact of these tools in reducing gender and racial/ethnic disparities and promoting health equity, mHealth tools tailored to Spanish-speaking people and transgender women are critically needed.”
The CDC’s new allocation will help meet that need since it will largely focus on transgender women of color, biological men who identify and present as women. “Transgender people, in particular transgender women, are disproportionately impacted by HIV,” the agency writes on its HIV prevention web page. “Providing high quality capacity building assistance to support HIV prevention programs and reduce disparities for transgender persons is an HIV prevention priority.” The CDC has already created a “Toolkit for Providing HIV Prevention Services to Transgender Women of Color” designed by “transgender women of color with extensive experience working in HIV prevention.” It assesses community needs, creates transgender-affirming environments, addresses mental and behavioral health needs for transgender women of color and builds community partnerships.
