Mobile phone applications for the care and prevention of HIV and other sexually transmitted diseases: a review

Abstract

Background: Mobile phone applications (apps) provide a new platform for delivering tailored human immunodeficiency virus (HIV) and sexually transmitted disease (STD) prevention and care.

Objective: To identify and evaluate currently available mobile phone apps related to the prevention and care of HIV and other STDs.

Methods: We searched the Apple iTunes and Android Google Play stores for HIV/STD-related apps, excluding apps that exclusively targeted industry, providers, and researchers. Each eligible app was downloaded, tested, and assessed for user ratings and functionality as well as 6 broad content areas of HIV prevention and care: HIV/STD disease knowledge, risk reduction/safer sex, condom promotion, HIV/STD testing information, resources for HIV-positive persons, and focus on key populations.

Results: Search queries up to May 2012 identified 1937 apps. Of these, 55 unique apps met the inclusion criteria (12 for Android, 29 for iPhone, and 14 for both platforms). Among these apps, 71% provided disease information about HIV/STDs, 36% provided HIV/STD testing information or resources, 29% included information about condom use or assistance locating condoms, and 24% promoted safer sex. Only 6 apps (11%) covered all 4 of these prevention areas. Eight apps (15%) provided tools or resources specifically for HIV/STD positive persons. Ten apps included information for a range of sexual orientations, 9 apps appeared to be designed for racially/ethnically diverse audiences, and 15 apps featured interactive components. Apps were infrequently downloaded (median 100-500 downloads) and not highly rated (average customer rating 3.7 out of 5 stars).

Conclusions: Most available HIV/STD apps have failed to attract user attention and positive reviews. Public health practitioners should work with app developers to incorporate elements of evidence-based interventions for risk reduction and improve app inclusiveness and interactivity.

Figure 1

Search and screening process for HIV/STD-related apps.

Figure 2

Screenshot of the iStayHealthy app’s user-generated CD4 cell count tracking. Android version shown on Samsung Galaxy S IV. Actual phone screen size: 9.6 × 5.5 cm. Reproduced with permission from creator, Dr Peter Schmidt.

Figure 3

Screenshot of iStayHealthy app’s user-generated HIV medication list. iPhone version shown on Apple iPhone 4. Actual phone screen size: 6.8 × 4.5 cm. Reproduced with permission from creator, Dr Peter Schmidt.

Figure 4

Screenshot of user placing a condom on a practice object in the interactive Condom Pro app. iPhone version shown on Apple iPad 2 for clarity. Reproduced with permission from Liz Sabatiuk, Social Media Manager, The National Campaign to Prevent Teen and Unplanned Pregnancy.

Figure 5

Screenshot of the MSM-tailored, interactive sexual behavior risk chart from STD411. iPhone version shown on Apple iPad 2 for clarity.

Figure 6

Screenshot of STDiQ app featuring racially/ethnically diverse videos from the Safe in the City STD reduction intervention. iPhone version shown on iPad 2 for clarity. Reproduced with permission from Cornelis A Rietmeijer, MD, PhD, MSPH, University of Colorado, Denver.

Figure 7

Screenshot of STDiQ app featuring a bar scene from Rueben’s one-night stand in the Safe in the City STD reduction intervention. iPhone version shown on iPad 2 for clarity. Reproduced with permission from Cornelis A Rietmeijer, MD, PhD, MSPH, University of Colorado, Denver.