Journal Article

Perceptions of HIV-Related Comorbidities and Usability of a Virtual Environment for Cardiovascular Disease Prevention Education in Sexual Minority Men With HIV: Formative Phases of a Pilot Randomized Controlled Trial

Ramos, S Raquel, Johnson, Constance, Vorderstrasse, Allison, Melkus, Gail, Reynolds, Harmony, Kershaw, Trace, Thayer, Julian F

2024

Overview

Sexual minority men with HIV are at an increased risk of cardiovascular disease (CVD) and have been underrepresented in behavioral research and clinical trials. This study aims to explore perceptions of HIV-related comorbidities and assess the interest in and usability of a virtual environment for CVD prevention education in Black and Latinx sexual minority men with HIV. This is a 3-phase pilot behavioral randomized controlled trial. We report on formative phases 1 and 2 that informed virtual environment content and features using qualitative interviews, usability testing, and beta testing with a total of 25 individuals. In phase 1, a total of 15 participants completed interviews exploring HIV-related illnesses of concern that would be used to tailor the virtual environment. In phase 2, usability testing and beta testing were conducted with 10 participants to assess interest, features, and content. In phase 1, we found that CVD risk factors included high blood pressure, myocardial infarction, stroke, and diabetes. Cancer (prostate, colon, and others) was a common concern, as were mental health conditions. In phase 2, all participants completed the 12-item usability checklist with favorable feedback within 30 to 60 minutes. Beta-testing interviews suggested (1) mixed perceptions of health and HIV, (2) high risk for comorbid conditions, (3) virtual environment features were promising, and (4) the need for diverse avatar representations. We identified several comorbid conditions of concern, and findings carry significant implications for mitigating barriers to preventive health screenings, given the shared risk factors between HIV and related comorbidities. Highly rated aspects of the virtual environment were anonymity; meeting others with HIV who identify as gay or bisexual; validating lesbian, gay, bisexual, transgender, queer, and others (LGBTQ+) images and content; and accessibility to CVD prevention education. Critical end-user feedback from beta testing suggested more options for avatar customization in skin, hair, and body representation. Our next phase will test the virtual environment as a new approach to advancing cardiovascular health equity in ethnic and racial sexual minority men with HIV. ClinicalTrials.gov NCT04061915; https://clinicaltrials.gov/study/NCT05242952. RR2-10.2196/38348.

• Publisher: Journal of Medical Internet Research,Gunther Eysenbach MD MPH, Associate Professor,JMIR Publications
• Subject: Access / Adult / Augmented reality / Bisexuality / Blood pressure / Cancer / Cardiovascular disease / Cardiovascular diseases / Cardiovascular Diseases - prevention & control / Care and treatment / Chronic illnesses / Clinical research / Clinical trials / Comorbidity / Data collection / Diabetes / Disease prevention / Education / Environment / Ethics / Feedback / Hair / Health aspects / Health disparities / Heart / HIV / HIV Infections - prevention & control / HIV Infections - psychology / HIV patients / Homosexuality / Human immunodeficiency virus / Humans / Hypertension / Interviews / Lesbianism / LGBTQ people / Male / Medical screening / Men / Mental health / Methods / Middle Aged / Minority & ethnic groups / Minority groups / Mortality / Myocardial infarction / Patient education / Perceptions / Pilot Projects / Prevention / Preventive medicine / Prostate cancer / Psychological aspects / Racism / Registration / Review boards / Risk factors / Sexual and Gender Minorities - psychology / Sexual and Gender Minorities - statistics & numerical data / Sexual minorities / Sexual orientation / Sexuality / Stroke / Telemedicine / Tests / Transgender persons / Usability / Usability testing / User-Computer Interface / Virtual Reality