Feasibility and preliminary effectiveness of POSSIBLE: A multicomponent intervention to improve perceived risk for HIV among Black sexual minority men (Preprint)

BACKGROUND Increased pre-exposure prophylaxis (PrEP) use is urgently needed to substantially decrease HIV incidence among Black sexual minority men (SMM). Low perceived risk for HIV (PRH) is also a key unaddressed PrEP barrier for Black SMM. Peers and smartphone apps have are popular intervention tools to promote community health behaviors but few studies have utilized these in a multicomponent strategy. Therefore, we designed a multicomponent intervention called POSSIBLE that utilized an existing smartphone app called PrEPme® and a peer change agent (PCA) to increase PRH as a gateway to PrEP introduction. This paper describes the feasibility and preliminary effectiveness of POSSIBLE on PRH and willingness to accept a PrEP referral among Black SMM. OBJECTIVE This paper describes the feasibility and preliminary effectiveness of POSSIBLE on PRH and willingness to accept a PrEP referral among Black SMM. METHODS POSSIBLE was a theoretically guided, single group, pre-post pilot study conducted among Black SMM from Baltimore, MD between 2019 and 2021. POSSIBLE implemented a culturally congruent PCA and a mobile smartphone app called PrEPme® that allows users to self-monitor sexual risk behaviors and chat with the in-app community health worker to obtain PrEP service information. PRH was assessed using the 8-item PRH scale before and after baseline and follow-up study visits. At the end of each study visit, the PCA referred interested individuals to the CHW to learn more about PrEP service options. RESULTS A total 69 Black SMM participated, 80% of whom were retained for follow-up at month 1. The average age of participants was 32.5 years (range=19-62, [SD=8.1]). After baseline sessions, 42% participants were willing to be referred to PrEP services; 69% of them confirmed scheduled appointments with PrEP care teams. There were no statistically significant differences in PRH between baseline and follow-up visits (Table 3, t=-1.36; p=0.17). CONCLUSIONS We observed no statistically significant improvement in PRH post-intervention. However, given the high retention rate, high acceptability, and strong participant satisfaction, POSSIBLE may be a feasible multicomponent strategy to implement among Black SMM. Future research should test a statistically powered peer-based approach on PrEP initiation among Black SMM. CLINICALTRIAL NCT04533386