# Adapting effective mhealth interventions to improve uptake and adherence of the HIV pre- exposure prophylaxis (PrEP) in Thai young MSM

> **NIH NIH R34** · UNIV OF MASSACHUSETTS MED SCH WORCESTER · 2021 · $266,246

## Abstract

Young men having sex with men (YMSM) are the fastest growing HIV+ population worldwide. Thailand has
the highest adult HIV seroprevalence in Asia; 28.6% of men having sex with men in Bangkok are HIV+. The
HIV incidence rate among YMSM in Bangkok is 12.2 per 100 person-years. Effective prevention strategies are
urgently needed to prevent HIV transmission in this high-risk population. Pre-exposure prophylaxis (PrEP) is
an efficacious HIV prevention strategy recommended by the CDC and WHO for all at-risk individuals,
including HIV-negative MSM. PrEP is highly effective when taken as prescribed, but PrEP utilization has been
low and adherence is often inadequate. To address these challenges among Thai YMSM, we propose to develop
a technology facilitated intervention combining Motivational Enhancement System for PrEP Uptake and
Adherence (MES-PrEP) and Motivational Interactive Text Messaging (MTM) to increase uptake of and
sustained adherence to PrEP among HIV-negative, Thai YMSM. MTM will be programmed and tested to send
two-way motivational messages to promote PrEP uptake and adherence. Our primary aim is to develop and
pilot test MES-PrEP and MTM and associated protocols and to assess preliminary evidence of the effect of the
technology facilitated intervention. The proposed study includes 3 phases. Phase I includes in-depth
interviews with 30 HIV-negative Thai YMSM to explore barriers and facilitators of PrEP initiation and
adherence to inform intervention content. Phase II consists of adapting and beta testing MES-PrEP and MTM
for functionality and feasibility using 10 HIV-negative Thai YMSM. In Phase III, we will conduct a pilot
randomized controlled trial to evaluate the feasibility, acceptability, and preliminary efficacy of MAS-PrEP and
MTM to increase PrEP uptake and adherence among Thai YMSM. We will enroll 60 HIV-negative Thai YMSM
who have not started PrEP and 60 YMSM who are on PrEP but not adherent to it. Participants will be
randomized 2:1 to received MES-PrEP and MTM (n=40) or Standard PrEP Counseling (n=20). Feasibility and
acceptability of the intervention will be assessed through paradata of usage patterns and the System Usability
Scale. Preliminary impact will be assessed by evaluating the proportion of PrEP initiation and level of
adherence to PrEP. Participants will complete the assessments at baseline and 1, 3, and 6 months post-
intervention. Biomarkers of adherence to PrEP and HIV/STI will be collected. Upon project completion, we
shall have developed a highly innovative mHealth intervention to support MSM using PrEP which will be ready
for testing in a larger efficacy trial.

## Key facts

- **NIH application ID:** 10258607
- **Project number:** 1R34MH124081-01A1
- **Recipient organization:** UNIV OF MASSACHUSETTS MED SCH WORCESTER
- **Principal Investigator:** NITTAYA PHANUPHAK
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $266,246
- **Award type:** 1
- **Project period:** 2021-07-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10258607

## Citation

> US National Institutes of Health, RePORTER application 10258607, Adapting effective mhealth interventions to improve uptake and adherence of the HIV pre- exposure prophylaxis (PrEP) in Thai young MSM (1R34MH124081-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10258607. Licensed CC0.

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