Trial Outcomes & Findings for eSTEP: An Integrated mHealth Intervention to Engage High-risk Individuals Along the Full PrEP Care Continuum (NCT NCT06159582)

NCT ID: NCT06159582

Last Updated: 2026-06-23

Results Overview

PrEP initiation was the percent of participants in each arm who started PrEP any time in the 24 weeks after enrollment. A participant was considered to have initiated if they had evidence in the medical record of starting PrEP at any point during the 6-month intervention period. Study staff performed a review of medical records, including clinical encounters and medication records to confirm PrEP initiation.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

113 participants

Primary outcome timeframe

Assess throughout the 24 weeks after study enrollment.

Results posted on

2026-06-23

Participant Flow

Participant milestones

Participant milestones
Measure
eSTEP Arm
Treatment group participants will be given access to the eSTEP (Electronic Support to Engage with PrEP) mobile app to promote engagement on the full PrEP care continuum plus usual PrEP clinical care. eSTEP includes the following components: PrEP information; Identifying and addressing barriers to starting PrEP; Information about stigma and managing stigma; Matching the best PrEP option to one's personal life circumstances; Appointment Scheduling; PrEP Adherence Reminders \& Self-monitoring for those who start PrEP; PrEP Appointment Reminders; a Frequently Asked Question (FAQ) section. eSTEP: eSTEP (Electronic Support to Engage with PrEP) is an mHealth intervention to promote engagement on the full PrEP care continuum and is tailored to MSM and TW. Usual Care: Usual PrEP clinical care
Control Arm
Usual PrEP clinical care Usual Care: Usual PrEP clinical care
Overall Study
STARTED
76
37
Overall Study
COMPLETED
76
37
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

eSTEP: An Integrated mHealth Intervention to Engage High-risk Individuals Along the Full PrEP Care Continuum

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
eSTEP Arm
n=76 Participants
Treatment group participants will be given access to the eSTEP (Electronic Support to Engage with PrEP) mobile app to promote engagement on the full PrEP care continuum plus usual PrEP clinical care. eSTEP includes the following components: PrEP information; Identifying and addressing barriers to starting PrEP; Information about stigma and managing stigma; Matching the best PrEP option to one's personal life circumstances; Appointment Scheduling; PrEP Adherence Reminders \& Self-monitoring for those who start PrEP; PrEP Appointment Reminders; a Frequently Asked Question (FAQ) section. eSTEP: eSTEP (Electronic Support to Engage with PrEP) is an mHealth intervention to promote engagement on the full PrEP care continuum and is tailored to MSM and TW. Usual Care: Usual PrEP clinical care
Control Arm
n=37 Participants
Usual PrEP clinical care Usual Care: Usual PrEP clinical care
Total
n=113 Participants
Total of all reporting groups
Age, Continuous
26.8 Years
STANDARD_DEVIATION 10.7 • n=20 Participants
43.3 Years
STANDARD_DEVIATION 11.8 • n=20 Participants
38.9 Years
STANDARD_DEVIATION 11.4 • n=40 Participants
Sex/Gender, Customized
Male
59 Participants
n=20 Participants
30 Participants
n=20 Participants
89 Participants
n=40 Participants
Sex/Gender, Customized
Transgender Woman
17 Participants
n=20 Participants
7 Participants
n=20 Participants
24 Participants
n=40 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
29 Participants
n=20 Participants
14 Participants
n=20 Participants
43 Participants
n=40 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
47 Participants
n=20 Participants
23 Participants
n=20 Participants
70 Participants
n=40 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=20 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=20 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
Race (NIH/OMB)
Asian
10 Participants
n=20 Participants
1 Participants
n=20 Participants
11 Participants
n=40 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants
n=20 Participants
1 Participants
n=20 Participants
2 Participants
n=40 Participants
Race (NIH/OMB)
Black or African American
9 Participants
n=20 Participants
8 Participants
n=20 Participants
17 Participants
n=40 Participants
Race (NIH/OMB)
White
50 Participants
n=20 Participants
23 Participants
n=20 Participants
73 Participants
n=40 Participants
Race (NIH/OMB)
More than one race
6 Participants
n=20 Participants
3 Participants
n=20 Participants
9 Participants
n=40 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=20 Participants
1 Participants
n=20 Participants
1 Participants
n=40 Participants
Region of Enrollment
United States
76 participants
n=20 Participants
37 participants
n=20 Participants
113 participants
n=40 Participants

PRIMARY outcome

Timeframe: Assess throughout the 24 weeks after study enrollment.

Population: All participants who enrolled on the study

PrEP initiation was the percent of participants in each arm who started PrEP any time in the 24 weeks after enrollment. A participant was considered to have initiated if they had evidence in the medical record of starting PrEP at any point during the 6-month intervention period. Study staff performed a review of medical records, including clinical encounters and medication records to confirm PrEP initiation.

Outcome measures

Outcome measures
Measure
Control Arm
n=37 Participants
Usual PrEP clinical care Usual Care: Usual PrEP clinical care
eSTEP Arm
n=76 Participants
Treatment group participants will be given access to the eSTEP (Electronic Support to Engage with PrEP) mobile app to promote engagement on the full PrEP care continuum plus usual PrEP clinical care. eSTEP includes the following components: PrEP information; Identifying and addressing barriers to starting PrEP; Information about stigma and managing stigma; Matching the best PrEP option to one's personal life circumstances; Appointment Scheduling; PrEP Adherence Reminders \& Self-monitoring for those who start PrEP; PrEP Appointment Reminders; a Frequently Asked Question (FAQ) section. eSTEP: eSTEP (Electronic Support to Engage with PrEP) is an mHealth intervention to promote engagement on the full PrEP care continuum and is tailored to MSM and TW. Usual Care: Usual PrEP clinical care
PrEP Initiation
10 Participants
22 Participants

PRIMARY outcome

Timeframe: Participants who were retained in PrEP care through week 12 after enrollment

Population: Participants who initiated PrEP at the baseline study visit and who were in PrEP care at week 12

Retention in PrEP care was assessed at 12 weeks based on documentation in the medical record during follow-up or clinical encounters. Participants were considered retained in care if they had initiated PrEP at the prior study visit and the clinician documented ongoing PrEP use during a follow-up clinical encounter or if there was evidence that the participant initiated a refill request in the absence of a visit as of the next study visit. At 12 weeks, participants were recorded as being retained in PrEP care (1) or not (0).

Outcome measures

Outcome measures
Measure
Control Arm
n=9 Participants
Usual PrEP clinical care Usual Care: Usual PrEP clinical care
eSTEP Arm
n=22 Participants
Treatment group participants will be given access to the eSTEP (Electronic Support to Engage with PrEP) mobile app to promote engagement on the full PrEP care continuum plus usual PrEP clinical care. eSTEP includes the following components: PrEP information; Identifying and addressing barriers to starting PrEP; Information about stigma and managing stigma; Matching the best PrEP option to one's personal life circumstances; Appointment Scheduling; PrEP Adherence Reminders \& Self-monitoring for those who start PrEP; PrEP Appointment Reminders; a Frequently Asked Question (FAQ) section. eSTEP: eSTEP (Electronic Support to Engage with PrEP) is an mHealth intervention to promote engagement on the full PrEP care continuum and is tailored to MSM and TW. Usual Care: Usual PrEP clinical care
Retention in PrEP Care at 12 Weeks
7 Participants
15 Participants

PRIMARY outcome

Timeframe: Participants who were retained in PrEP care at week 24

Population: Participants who initiated PrEP at a previous study visit and who were retained in PrEP care at week 24

Retention in PrEP care was assessed at 24 weeks based on documentation in the medical record during follow-up or clinical encounters. Participants were considered retained in care if they had initiated PrEP at the prior study visit and the clinician documented ongoing PrEP use during a follow-up clinical encounter or if there was evidence that the participant initiated a refill request in the absence of a visit as of the next study visit. At 24 weeks, participants were recorded as being retained in PrEP care (1) or not (0).

Outcome measures

Outcome measures
Measure
Control Arm
n=10 Participants
Usual PrEP clinical care Usual Care: Usual PrEP clinical care
eSTEP Arm
n=22 Participants
Treatment group participants will be given access to the eSTEP (Electronic Support to Engage with PrEP) mobile app to promote engagement on the full PrEP care continuum plus usual PrEP clinical care. eSTEP includes the following components: PrEP information; Identifying and addressing barriers to starting PrEP; Information about stigma and managing stigma; Matching the best PrEP option to one's personal life circumstances; Appointment Scheduling; PrEP Adherence Reminders \& Self-monitoring for those who start PrEP; PrEP Appointment Reminders; a Frequently Asked Question (FAQ) section. eSTEP: eSTEP (Electronic Support to Engage with PrEP) is an mHealth intervention to promote engagement on the full PrEP care continuum and is tailored to MSM and TW. Usual Care: Usual PrEP clinical care
Retention in PrEP Care at 24 Weeks
6 Participants
10 Participants

PRIMARY outcome

Timeframe: Assessed at 12 weeks after study enrollment

Population: Participants who had initiated PrEP at 12 weeks or at a prior study visit

Protective PrEP adherence for oral PrEP was assessed through analysis of TFV-DP levels from DBS specimens obtained using self-collection kits. Tenofovir diphosphate (TFV-DP) levels were categorized as either protective (corresponding with ≥4 doses per week) or not protected (≤3 doses per week). For participants on injectable PrEP, timely PrEP injections (receiving an injection within 2 weeks of the ideal injection date) was used to determine whether they were protected or not protected.

Outcome measures

Outcome measures
Measure
Control Arm
n=10 Participants
Usual PrEP clinical care Usual Care: Usual PrEP clinical care
eSTEP Arm
n=22 Participants
Treatment group participants will be given access to the eSTEP (Electronic Support to Engage with PrEP) mobile app to promote engagement on the full PrEP care continuum plus usual PrEP clinical care. eSTEP includes the following components: PrEP information; Identifying and addressing barriers to starting PrEP; Information about stigma and managing stigma; Matching the best PrEP option to one's personal life circumstances; Appointment Scheduling; PrEP Adherence Reminders \& Self-monitoring for those who start PrEP; PrEP Appointment Reminders; a Frequently Asked Question (FAQ) section. eSTEP: eSTEP (Electronic Support to Engage with PrEP) is an mHealth intervention to promote engagement on the full PrEP care continuum and is tailored to MSM and TW. Usual Care: Usual PrEP clinical care
Protective PreP Adherence at 12 Weeks
4 Participants
13 Participants

PRIMARY outcome

Timeframe: Assessed at 24 weeks after study enrollment

Population: Participants who had initiated PrEP at 24 weeks or at a prior study visit

Protective PrEP adherence for oral PrEP was assessed through analysis of TFV-DP levels from DBS specimens obtained using self-collection kits. Tenofovir diphosphate (TFV-DP) levels were categorized as either protective (corresponding with ≥4 doses per week) or not protected (≤3 doses per week). For participants on injectable PrEP, timely PrEP injections (receiving an injection within 2 weeks of the ideal injection date) was used to determine whether they were protected or not protected.

Outcome measures

Outcome measures
Measure
Control Arm
n=10 Participants
Usual PrEP clinical care Usual Care: Usual PrEP clinical care
eSTEP Arm
n=22 Participants
Treatment group participants will be given access to the eSTEP (Electronic Support to Engage with PrEP) mobile app to promote engagement on the full PrEP care continuum plus usual PrEP clinical care. eSTEP includes the following components: PrEP information; Identifying and addressing barriers to starting PrEP; Information about stigma and managing stigma; Matching the best PrEP option to one's personal life circumstances; Appointment Scheduling; PrEP Adherence Reminders \& Self-monitoring for those who start PrEP; PrEP Appointment Reminders; a Frequently Asked Question (FAQ) section. eSTEP: eSTEP (Electronic Support to Engage with PrEP) is an mHealth intervention to promote engagement on the full PrEP care continuum and is tailored to MSM and TW. Usual Care: Usual PrEP clinical care
Protective PrEP Adherence at 24 Weeks
2 Participants
13 Participants

Adverse Events

eSTEP Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Control Arm

Serious events: 1 serious events
Other events: 0 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
eSTEP Arm
n=76 participants at risk
Treatment group participants will be given access to the eSTEP (Electronic Support to Engage with PrEP) mobile app to promote engagement on the full PrEP care continuum plus usual PrEP clinical care. eSTEP includes the following components: PrEP information; Identifying and addressing barriers to starting PrEP; Information about stigma and managing stigma; Matching the best PrEP option to one's personal life circumstances; Appointment Scheduling; PrEP Adherence Reminders \& Self-monitoring for those who start PrEP; PrEP Appointment Reminders; a Frequently Asked Question (FAQ) section. eSTEP: eSTEP (Electronic Support to Engage with PrEP) is an mHealth intervention to promote engagement on the full PrEP care continuum and is tailored to MSM and TW. Usual Care: Usual PrEP clinical care
Control Arm
n=37 participants at risk
Usual PrEP clinical care Usual Care: Usual PrEP clinical care
General disorders
Suicide
0.00%
0/76 • Adverse event data were collected over a period of 6 months.
2.7%
1/37 • Number of events 1 • Adverse event data were collected over a period of 6 months.

Other adverse events

Adverse event data not reported

Additional Information

Dr. Keith Horvath

San Diego State University

Phone: 6196943346

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place