Black women’s preferences regarding use of mHealth for sexual health support in Chicago, a cross-sectional study

Black women are disproportionally likely to contract sexually transmitted infections (STIs) including HIV compared to women of other races and ethnicities. It is possible that mobile health (referred to as “mHealth”) strategies, including mobile applications, designed for Black women could provide sexual health support and reduce STI/HIV transmission. We sought to explore acceptability of mHealth strategies among Black women and to identify if preferences varied by age or HIV vulnerability. We surveyed 213 Black women aged 14-64 attending a family planning clinic in Chicago. We asked about mHealth use, desired sources of sexual health information, and mHealth application (app) features. Responses were analyzed as dichotomous variables, with age categorized as <=24 years of age or >=25 years of age and HIV vulnerability score categorized as low (<2) or high (>=2). HIV vulnerability was determined based on affirmative answers to the following questions: having had condomless sex (either vaginal or anal) in the past three months, having had an abortion in the past 12 months, having received STI treatment in the past three months, and having had >=2 sex partners in the last three months. Odds ratios and 95% confidence intervals (OR 95% CI) were created using logistic regression models. The majority of participants were interested in using technology as part of their sexual health care (84.5%) and were likely to download an mHealth app (74.7%). Many questions about desirability and interest in app features did not differ by age or HIV vulnerability category. Black women >=25 years had 7.3 times the odds of rating the inclusion of short videos as an important part of the mHealth app (OR 7.3 95% CI (1.7, 32.4)). Within this population, interest in using a sexual health app was high, suggesting an openness to app development for both sexual health as well as specifically for pre-exposure prophylaxis.

与其他种族和族裔女性相比，黑人女性感染包括人类免疫缺陷病毒（HIV）在内的性传播感染（sexually transmitted infections, STIs）的风险显著更高。针对黑人女性开发的包含移动应用在内的移动健康（mobile health, mHealth）策略，或可为其提供性健康支持并降低性传播感染/HIV传播风险。本研究旨在探究黑人女性对mHealth策略的接受度，并明确其相关偏好是否会因年龄或HIV感染易感性而存在差异。我们对芝加哥某计划生育诊所就诊的213名年龄介于14至64岁的黑人女性开展了问卷调查，问卷内容涵盖mHealth使用情况、理想的性健康信息获取渠道，以及mHealth应用程序（app）功能偏好。调查结果以二分变量形式进行分析，其中年龄被划分为≤24岁与≥25岁两组，HIV感染易感性评分则分为低评分（<2分）与高评分（≥2分）两组。HIV感染易感性通过以下问题的肯定回答数量判定：过去三个月内有无无保护性行为（包括阴道性交或肛交）、过去12个月内是否曾流产、过去三个月内是否接受过性传播感染治疗，以及过去三个月内是否有≥2个性伴侣。本研究通过逻辑回归模型计算比值比（odds ratio, OR）与95%置信区间（95% confidence interval, 95% CI）。绝大多数受试者对将技术手段纳入性健康诊疗服务表示感兴趣（占比84.5%），且有意愿下载mHealth应用程序（占比74.7%）。多数关于应用功能偏好与使用意愿的调查结果，并未因年龄分组或HIV感染易感性分组而存在显著差异。年龄≥25岁的黑人女性将短视频纳入mHealth应用程序视为核心功能的可能性是≤24岁群体的7.3倍（OR=7.3，95% CI：1.7~32.4）。该人群对性健康应用程序的使用意愿较高，提示其对性健康类应用，以及专门用于暴露前预防（pre-exposure prophylaxis）的应用程序开发均持开放态度。