Evidence map›Paper›PMID 39137407›Full record

ArticleJMIR formative research2024

Adaptation of a Theory-Based Mobile App to Improve Access to HIV Prevention Services for Transgender Women in Malaysia: Focus Group Study.

Kamal Gautam, Roman Shrestha, Sihlelelwe Dlamini, Belle Razali, Kiran Paudel, Iskandar Azwa, Rumana Saifi, YuHang Toh, Hazriq Justin Lim, Ryan Sutherland and 3 more

Abstract read
In one paragraph

Article in JMIR formative research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. International journal of transgender health · 2026
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Kamal GautamDepartment of Allied Health Sciences, University of Connecticut, Storrs, CT, United States.ORCID https://orcid.org/0000-0002-7121-7421
Roman ShresthaDepartment of Allied Health Sciences, University of Connecticut, Storrs, CT, United States.ORCID https://orcid.org/0000-0003-4340-3101
Sihlelelwe DlaminiDepartment of Allied Health Sciences, University of Connecticut, Storrs, CT, United States.ORCID https://orcid.org/0009-0008-9308-1095
Belle RazaliCentre of Excellence for Research in AIDS, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.ORCID https://orcid.org/0009-0007-6603-9572
Kiran PaudelDepartment of Allied Health Sciences, University of Connecticut, Storrs, CT, United States.ORCID https://orcid.org/0000-0002-5590-4133
Iskandar AzwaCentre of Excellence for Research in AIDS, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.ORCID https://orcid.org/0000-0003-1977-6709
Rumana SaifiCentre of Excellence for Research in AIDS, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.ORCID https://orcid.org/0000-0001-9114-4728
YuHang TohCentre of Excellence for Research in AIDS, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.ORCID https://orcid.org/0009-0005-1127-5821
Hazriq Justin LimCentre of Excellence for Research in AIDS, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.ORCID https://orcid.org/0009-0007-5777-8285
Ryan SutherlandDepartment of Internal Medicine, Yale School of Medicine, New Haven, CT, United States.ORCID https://orcid.org/0000-0002-3821-2549
Arjee RestarDepartment of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States.ORCID https://orcid.org/0000-0003-2992-8198
Nittaya PhanuphakInstitute of HIV Research and Innovation, Bangkok, Thailand.ORCID https://orcid.org/0000-0002-0036-3165
Jeffrey A WickershamDepartment of Internal Medicine, Yale School of Medicine, New Haven, CT, United States.ORCID https://orcid.org/0000-0001-7701-9162

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
NCATS NIH HHS UL1 TR001863
6 · The paper itself

Abstract

backgroundGlobally, transgender women have been disproportionately affected by the HIV epidemic, including in Malaysia, where an estimated 11% of transgender women are living with HIV. Available interventions designed specifically to meet transgender women's needs for HIV prevention are limited. Mobile health, particularly smartphone mobile apps, is an innovative and cost-effective strategy for reaching transgender women and delivering interventions to reduce HIV vulnerability.

objectiveThis study aims to adapt a theory-based mobile health HIV prevention smartphone app, HealthMindr, to meet the unique needs of transgender women in Malaysia. We conducted theater testing of the HealthMindr app with transgender women and key stakeholders and explored barriers to transgender women's uptake of HIV pre-exposure prophylaxis (PrEP).

methodsFrom February to April 2022, a total of 6 focus group (FG) sessions were conducted with 29 participants: 4 FG sessions with transgender women (n=18, 62%) and 2 FG sessions with stakeholders (n=11, 38%) providing HIV prevention services to transgender women in Malaysia. Barriers to PrEP uptake and gender-affirming care services among transgender women in Malaysia were explored. Participants were then introduced to the HealthMindr app and provided a comprehensive tour of the app's features and functions. Participants provided feedback on the app and on how existing features should be adapted to meet the needs of transgender women, as well as any features that should be removed or added. Each FG was digitally recorded and transcribed. Transcripts were coded inductively using Dedoose software (version 9.0.54; SocioCultural Research Consultants, LLC) and analyzed to identify and interpret emerging themes.

resultsSix subthemes related to PrEP barriers were found: stigma and discrimination, limited PrEP knowledge, high PrEP cost, accessibility concerns, alternative prevention methods, and perceived adverse effects. Participants suggested several recommendations regarding the attributes and app features that would be the most useful for transgender women in Malaysia. Adaptation and refinement of the app were related to the attributes of the app (user interface, security, customizable colors, themes, and avatars), feedback, and requests for additional mobile app functional (appointment booking, e-consultation, e-pharmacy, medicine tracker, mood tracker, resources, and service site locator) and communication (peer support group, live chat, and discussion forum) features.

conclusionsThe results reveal that multifaceted barriers hinder PrEP uptake and use among transgender women in Malaysia. The findings also provide detailed recommendations for successfully adapting the HealthMindr app to the context of Malaysian transgender women, with a potential solution for delivering tailored HIV prevention, including PrEP, and increasing accessibility to gender-affirming care services.

Indexed as

AIDSHIVMalaysiamHealthmobile healthmobile phonepre-exposure prophylaxisPrEPtransgender women

Identifiers

PMID39137407
PMCPMC11350319

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.