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SMARTtest: A Smartphone App to Facilitate HIV and Syphilis Self- and Partner-Testing, Interpretation of Results, and Linkage to Care

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Acceptability of rapid HIV self-testing is high but potential users remain concerned about correct use, interpretation of test results, and linkage to care. This article describes user preferences for a smartphone app to mitigate these challenges and how these were integrated into the SMARTtest app to support self- and partner-testing using the INSTI Multiplex®. Sixty men and transgender women who have sex with men self-tested for HIV and syphilis while guided by a prototype app that provided a video, pictorial step-by-step instructions, and sample test results presented textually (“positive,” “negative”). Subsequently, participants provided feedback on revisions and additional app content. Participants recommended offering different user modes (self, partner, both), and retaining the video, step-by-step instructions, and textual test results. They strongly favored the ability to save and send test results to sexual partners or providers. These features were integrated into the SMARTtest app to facilitate HIV/syphilis self- and partner-testing, HIV/syphilis status awareness and disclosure, and linkage to care.


La aceptabilidad de las auto-pruebas rápidas del VIH es alta pero sigue habiendo preocupaciones sobre el uso correcto, la interpretación de los resultados, y el enlace a la atención médica. Este artículo describe las preferencias de usuarios para una aplicación de teléfonos inteligentes para mitigar estos retos y como estas fueron integradas a la app SMARTtest para apoyar las auto-pruebas y pruebas con parejas para VIH y sífilis con el INSTI Multiplex®. Sesenta hombres y mujeres transgénero que tienen sexo con hombres se auto-realizaron una prueba de VIH y sífilis guiados por una app prototipo que proveyó instrucciones paso-a-paso en forma de video y foto, y resultados presentados en forma de texto (“positivo,” “negativo”). Después, los participantes fueron entrevistados a fondo para proveer retroalimentación sobre posibles revisiones y contenido adicional de la app. Los participantes sugirieron incorporar diferentes modos de usuarios (Yo, Mi pareja, Ambos), recomendaron retener el video, las instrucciones paso-a-paso, y los resultados en forma textual. Ellos favorecieron fuertemente la capacidad de guardar y enviar los resultados de las pruebas a parejas o a proveedores de salud. Todas estas funciones fueron integradas en la versión final de SMARTtest para facilitar el uso de pruebas de VIH/sífilis con parejas y para auto-pruebas, el conocimiento y divulgación de estados de VIH/sífilis, y el enlace a la atención médica.

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This research was supported by grants from the U.S. National Institutes of Health: R01-HD088156 (PI: I. Balán) and P30-MH43520 (PI: R. Remien). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Correspondence to Iván C. Balán.

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Balán, I.C., Lopez-Rios, J., Nayak, S. et al. SMARTtest: A Smartphone App to Facilitate HIV and Syphilis Self- and Partner-Testing, Interpretation of Results, and Linkage to Care. AIDS Behav 24, 1560–1573 (2020).

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