Development of I-HASMEA: A Participatory Action Research Study of a Mobile HIV Self-Management Application for Men Who Have Sex With Men Living With HIV in Thailand

ABSTRACT: Thai men who have sex with men (MSM) living with HIV face stigma and fragmented care that undermine effective self-management. Although mobile health (mHealth) interventions show promise, culturally grounded nurse-led digital solutions remain limited in low- and middle-income settings. This formative study developed the Interactive HIV/AIDS Self-Management Education Application using a nurse-led participatory action research approach. Three iterative cycles-exploration, co-design, and evaluation-engaged MSM living with HIV, nurses, clinicians, and information technology specialists to ensure contextual relevance, privacy, sensitivity, and usability. The finalized prototype integrates tailored self-management education, symptom and mood tracking, and medication reminders. Usability testing with nine participants demonstrated excellent perceived usability (median system usability scale score = 87.5, interquartile range = 82.5-90.0; observed range = 78.8-92.5). The M (SD) system usability scale score was 86.4 (5.8) on a possible range of 0-100. Findings support feasibility and usability and inform future effectiveness and implementation research.