Designing a Gamified mHealth App for HIV Prevention and Comorbidities Among Malaysian Young Men Who Have Sex With Men: An Interdisciplinary Expert Panel Study.

Abstract

New HIV cases among Malaysian men who have sex with men continue to rise, with young men who have sex with men (YMSM) accounting for 44% of new infections and experiencing high rates of comorbidities. Mobile health (mHealth) apps offer a promising approach to addressing these challenges by providing discreet access to health information, screening tools, and linkage to services. Given the near-universal smartphone ownership among Malaysian YMSM and high levels of mobile gaming engagement, gamified mHealth apps may be particularly effective in sustaining engagement and promoting HIV prevention behaviors and comorbidity management. However, realizing their full potential requires identifying the features and design principles that are most important to Malaysian YMSM and that can support sustained engagement and improve health outcomes in this vulnerable population. This study used an interdisciplinary expert panel approach to identify the key features, design principles, and gamification elements to be incorporated into MY-Hero, a gamified mHealth app designed to support HIV prevention, comorbidity management, and overall well-being among Malaysian YMSM. Guided by the integrated behavioral model (IBM), we conducted an interdisciplinary expert panel comprising experts in health, technology, and design sciences, as well as health care professionals with expertise in the Malaysian YMSM population, along with local lesbian, gay, bisexual, transgender, queer, and others (LGBTQ+) community leaders. Through a structured series of discussions and thematic analysis, we identified culturally appropriate design principles and key features for MY-Hero that align with the health needs and sociocultural context of Malaysian YMSM. Three expert panel sessions were conducted with 9 experts. Several key themes emerged: (1) the importance of establishing clinical affiliation and facilitating linkage to HIV testing, pre-exposure prophylaxis (PrEP), and related services, including harm reduction services; (2) the need to enhance user interface (UI) and user experience (UX) by optimizing usability, interactivity, and engagement to maintain user interest; (3) the incorporation of customizable health content to tailor interventions based on individual characteristics and preferences; (4) the use of gamification mechanisms, such as reward systems and progression tracking to promote adoption and sustained engagement with health services; and (5) the importance of privacy and data security as critical design considerations for ensuring user safety, confidentiality, and trust. The findings highlight the importance of user-centered design, contextualized health content, and gamification mechanisms in mHealth tools for Malaysian YMSM. These insights provide practical guidance for developing culturally appropriate gamified mHealth interventions for vulnerable populations by informing strategies to enhance user engagement, reduce HIV prevention fatigue, and support the well-being of YMSM in stigmatized contexts.