Table 1:
Participant themes about experiences with the SMARTtest app and illustrative text examples
| Description of theme (n=participants that endorsed the given theme) | Text example |
|---|---|
| Partners’ responses to the idea of using the SMARTtest app (n=5 used SMARTtest with partners) | |
| Partners were open to the idea of using SMARTtest (n=5) | I just tell them, ‘The computer is going to tell us. It’s an artificial intelligence thing that tells us’… I’m saying it’s all about the street talk, girl. Mama is all about the talk… It’s an AI. It’s going to tell us your [INSTI Multiplex® result] -- they were like, “For real?” Yeah. It is... (laughter) (1079) … [He was] Easygoing [about the test results displaying on the SMARTtest app]. It was just the wait period for the dots to show up -- whatever dot was going to show up to show up because he was nervous. (1083) |
| Participant “likes” and “dislikes” about the SMARTtest app (n=8 reported on this topic) | |
| SMARTtest is easy to use and convenient (n=6) | “It’s easy to navigate, you know? And like, you’re very patient and you went, and you downloaded, and you showed me like what the videos are. And then, like, if you forget where the video’s located to kind of like watch it and listen to it, because, you know, to play it again… The color is like bold, you know. It’s bold and it’s easily readable. It’s not like difficult language, you know?” (1118) “So before I even did the test -- because I did it here and I looked at the video, but it’s different because when you get home you might if you get [stressed?] and they let me watch the video again. So I watched the video, [had the video?], I just went through the process and just did it. And it’s so easy. It’s the easiest thing in the world to do. I mean -- a child could do it. The instructions are so clear. It’s not like you have to guess on anything. Three tubes. Prick your finger. The tubes are numbered. So it’s not like you have to guess about anything. Once it goes down, pour. Goes down, pour. And just wait for the results. That’s it.” (1121) |
| Like with many first versions of smartphone apps, SMARTtest requires additional refining for optimal functionality (n=7) | The app was very difficult…. It didn’t work… Because, again, it comes down to who your cellphone company’s with and it’s not compatible with all phones just quite yet… Because you got a lot of different phones out there… A lot of hard -- I had an issue with downloading the results… It wouldn’t take. And I have a Stylo 4. I know somebody else that had an iPhone and had no problems with it…So it’s also based on the phone. (1080) It doesn’t let you -- it says take notes or resources. When you hit resources, nothing happens. And then it’s too much video -- paper that you got to hit next, next, next, next, next, next, next, next, next while you were doing with the number one, number two, number three, open this, open that, put this to the side. It’s -- you re-- it gets repetitive so many times that close it and it’s a turn off. (1079) |
| Experiences with app instructions on how to use the INSTI Multiplex® and app features and resources (n=7 reported on this topic) | |
| Participants found the instructions presented on the SMARTtest app helpful to complete the test procedures correctly (n=5) | “With him I definitely used the instructions because before that I had only tested twice, and the first time was here. So it was just like I ran through it, not really maintain it. And then the second time I did it on my own, I totally forgot everything I was told, so I had to look at it.” (1102) It’s [instructions presented on the SMARTtest app] much more easy to understand than instructions [presented with the INSTI Multiplex® kit]” (1081) |
| Participants reported the most frequently used feature on the SMARTtest app was the information on clinics that offered confirmatory testing (n=5) | Oh I looked at clinics – which is actually helpful. The clinics. Because it explains to you if this is going on this is where you can go. So it’s good featured that’s in there because some people they don’t want to go to their primary care. Some people don’t have a primary care doctor. So it lets you know exactly where you can go if it says negative. You know for all positive – for anything – because it’s giving you posi–it’s for syphilis and HIV. So if you see the syphilis sign you can go get tested – go get treated. (1121) Clinics, yeah. That one I used the clinic part for like referrals, if anyone asked… Like instead of Googling, you know. Just like, I go into the app and I know where clinics are. (1102) |
| Privacy (n=8 reported on this topic) | |
| Participants and their partners did not have privacy concerns related to SMARTtest (n=6) | “…the app is very private. It’s ID number, results, date, delete it or not and that’s it. It was very convenient. It was very private. It was very discrete.” (1089), “…I just told them, ‘Look, it’s a app. I found the app.’ And they wanted me to try out stuff..” (1124) |
| Participants anticipated that they or their partners could have privacy concerns if INSTI Multiplex® detected a positive result (n=4) | “Well, for me personally, it [displaying a positive result on the SMARTtest app] doesn’t bother me. But I would assume it would fuck with everybody else, you know?” (1126) “…I mean, they just told me, if – ‘Don’t be afraid that somebody share your results some day and if it’ll be positive?’ I mean personally, I’m fine with it, you know? Data fixed everywhere. Because – I have nothing to hide, actually… But, yeah, I think it can be another problem, when they upload the result and people can -- I know -- I know like 10% of my friends are worrying about privacy. And even one of them would -- so she is a trans woman. For example, I ask her, ‘Why are you so worrying if your data’s -- What are you hiding’ And she told me we should just resist and to make it hard. And, yeah, maybe she’s right. I don’t know. (laughs). Yeah. I’m not, personally [concerned about the privacy of SMARTtest], but I’m not sure. There is 10%, certainly they do have a concern.” (1081) |
| Users’ recommendations for future versions of SMARTtest (n=9 reported on this topic) | |
| Participants provided recommendations on additional features, content, or functionality to be incorporated (n=6) | Yes. Like, I feel like for the results that indicate that syphilis is positive, it should have a little something under that says, you know, like ‘Secondary testing should be done to confirm if it is active or previously treated.’ Something like that… You know, like how they do for the HIV, like if it comes up positive? ‘Secondary testing should be performed.’ (1102) Leave it [save participant login information to the SMARTtest login screen] on the app on the phone like that because people can get their cell phones and that’s where they can keep everything, all the information and everything you need. You can go to the app and say, “Look. Boom, boom, boom.” Instead of writing it on a piece of paper and you got it in your bag, “Oh my God, I lost the paper. Now I don’t have the paper with me.” But everything is right on your phone it’s like one, two, three and A, B, Cs and that. It’s much better. (1083) |
| Participants provided ideas on how to improve existing SMARTtest navigation and functionality (n=5) | I would like to have the results -- get started, results, and everything that’s at the bottom of the other pages should be right here [the resources page] instead. And also at the bottom of each page, like the resources and all of that. Because it’s -- this is like OK, boom… Yes, yes, yes, yes, instead of having to go through all this [scroll through the screens on how to use the INSTI Multiplex®] because I already know how to use the test. And by the time I get to be right here [the main page], all of this is already done. So, the only thing I need to do is take the picture and it’s like I’ve got to go through all of this to take the picture. (1089) …I always had to put in -- you know when the -- when you open up the app and it says, “Who are you testing, you or your partner?”, and then it says “You cannot save partner.” That is so useless. If you’re going to test partner, you want that to be saved… I used to take a little notepad and write the third test I did was the guy I met in [place of work]. That’s where I work. The -- it says that you could take notes. You can’t take notes. So you got to fix that. Please fix that. (1079) |
| A minority of participants wanted to modify the overall “look” of the SMARTtest app to improve its visual appeal to users (n=2) | …it looks like a fucking -- what you call it? It looks like a test app. It doesn’t look like an app that you would put out there. It’s like the font, the language, the pictures, all of that needs to be like in one…. (1089) Put bright colors. Use nice fonts. It’s so institutional. It feels institutional. And when -- well me -- dealing with me, I don’t like things to feel institutional… I’m not really homey, I’m not sort of -- with my lifestyle. Put the [transgender pride] flag up in a corner -- a little corner with the flag, and maybe a girl with long hair, and a hand with long fingernails. Tonterias [silly things] like that. Stupid little things that’ll make you laugh and giggle. Especially when you’re about to suck a dick. You don’t want it to seem -- shit, I’m fucking doing an institutional thing -- I feel like I got the Feds hearing me. (1079) |