HealthMpowerment Korea: Pilot Testing the Cultural Adaptation of a Digital HIV Intervention for Men Who Have Sex With Men in South Korea

This pilot study evaluates Bandi, a culturally adapted digital HIV prevention intervention for young Korean men who have sex with men (MSM). Bandi is adapted from HealthMpowerment (HMP 2.0), an evidence-informed, status-neutral digital health platform designated by the U.S. Centers for Disease Control and Prevention (CDC) for HIV risk reduction. Guided by Barrera and Castro's heuristic model for cultural adaptation, the trial represents Phase 3 (preliminary adaptation testing) following preliminary information gathering and beta testing (N=10).

Participants randomized to the full intervention arm receive 3-month access to the complete Bandi platform, consisting of five core integrated components:

• Resource Center (Activities & Articles): Culturally tailored educational materials, pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) adherence strategies, interactive quizzes, and skill-building activities.
• Forums: Moderated online discussion forums and structured polls facilitating peer-to-peer support on topics including relationships, stigma, and sexual health.
• Love Log: An interactive self-monitoring tool allowing users to log past sexual encounters, plan future encounters, track behavioral patterns, and evaluate risk.
• Care Locator: A map database identifying local, culturally sensitive HIV and STI testing facilities.
• Gamification: Engagement features including customizable avatars and accomplishment badges.

The control arm receives access restricted to static health articles and the Care Locator component.

The study is conducted remotely in South Korea through a partnership between the University of Pennsylvania and Ewha Womans University. Local recruitment and participant communication are managed by trained staff at Ewha Womans University in collaboration with community stakeholder collectives.

In addition to self-reported web-based survey data (Qualtrics) collected at baseline and 3 months, application engagement will be continuously monitored via passively recorded paradata (e.g., module usage, login frequency, feature interactions). Statistical analyses will follow an intent-to-treat (ITT) approach. Chi-square/Fisher's Exact tests and Wilcoxon Two-Sample tests will evaluate preliminary differences between study arms regarding primary outcomes (routine HIV testing rates, reduction in condomless anal intercourse) and secondary outcomes (PrEP awareness/uptake, everyday discrimination, social support, depression, anxiety, and resilience).

Inclusion criteria

• Male sex assigned at birth and current male gender identity
• Aged 18 to 35 years
• Current residence in the Seoul Metropolitan area
• Korean nationality
• Self-identify as a sexual minority (e.g., gay, bisexual, queer, or other non-heterosexual identity)
• HIV-negative or HIV-unaware serostatus
• Report at least 1 episode of condomless anal intercourse with a male partner in the prior 6 months

Exclusion criteria

• Assigned female at birth or do not currently identify as male
• Younger than 18 or older than 35 years of age
• Non-residence in the Seoul Metropolitan area
• Do not hold Korean nationality
• Do not identify as a sexual minority
• Known HIV-positive status
• No reported episodes of condomless anal intercourse with a male partner in the prior 6 months