P3 (Prepared, Protected, emPowered): Promoting PrEP adherence through a social networking, gamification, and adherence support app
P3 is a three arm, randomized-controlled trial (RCT) that will test the efficacy of the P3, a novel, theory-based mobile app that utilizes game mechanics and social networking features to improve PrEP adherence, retention in PrEP clinical care and PrEP persistence among young men who have sex with men (YMSM) and trans women who have sex with men (YTW), ages 16-24. We will test the efficacy of P3 and P3+, which adds Next Step Counseling delivered by an adherence counselor through the app, against PrEP standard of care. Participants will be randomized to P3, P3+, or standard of care. A cost comparison between P3 and P3+ will be conducted.
The total duration of study participation for each subject is 6 months. The duration of the intervention arms is 3 months.
Total study sample is ~265 of which the following will be enrolled for each phase: 1) Usability testing with 8-12 total youth at 2 iTech subject recruitment venues; 2) Field testing will be conducted with 15 total youth who have recently initiated PrEP or are PrEP non-adherent at 3 iTech SRVs; 3) The RCCT will be conducted with 240 youth who plan to initiate PrEP, recently initiated PrEP or are PrEP non-adherent at 7 SRVs. The P3, P3+, and standard of care arm will each include 80 participants.
- Ages 16-24
- Assigned male sex at birth
- Report sex with men
- Able to speak and read English; 5) reliable daily access to an Android or iOS smartphone with a data plan
- HIV-uninfected (self-report)
- Not currently on PrEP but plan to initiate in the next 7 days and have an active PrEP prescription (prescription confirmed by study staff) OR initiated PrEP within the last 30 days (<30 days) and have an active PrEP prescription (prescription confirmed by study staff) OR on PrEP >30 days but self-report adherence on average < 6 pills per week over the past month and have an active PrEP prescription (prescription confirmed by study staff)
- Recruited from one of 8 iTech SRV cities (Atlanta, Georgia; Boston, Massachusetts; Bronx, New York; Chapel Hill, North Carolina; Chicago, Illinois; Houston, Texas; Philadelphia, Pennsylvania; Tampa, Florida)
- Willing to adhere to study collection of whole blood specimens
- To optimize the final components P3 and the adherence counseling intervention using iterative design and usability testing.
- To test the efficacy of the P3 intervention app among 240 young men who have sex with men (YMSM) and trans women who have sex with men, ages 16-24, by conducting a three-arm RCT with assessments at Baseline and Week 13 (end of intervention phase) and Week 26 (post-intervention phase). The primary outcome measure is PrEP adherence measured by intracellular tenofovir-diphosphate (TFV-DP) levels from dried blood spots collected at Weeks 13 and 26.
- To conduct a cost comparison between P3 and P3+.