“Let me see your App!”: A grounded theory exploration of electronic personal health records and HIV/STD prevention conversations at a HBCU

Background: Students at Historically Black Colleges and Universities (HBCUs) are at increased risk for HIV /STDs compared to those at Predominantly White Institutions. The eSHINE Study is a mixed-methods exploration on perceptions of exchanging HIV/STD screening information with partners using electronic personal health records (PHRs). We report findings of the qualitative phase.

Objective: We conducted a Grounded Theory study to explore perceptions of using PHRs in prevention conversations among students ages 18 -25 years at an HBCU.

Methods: Three audio-recorded focus groups and eighteen individual interviews were conducted with a sample of thirty-five students (nineteen men and fifteen women), including participants self-identifying as MSM, members of Greek organizations, and student athletes. Analysis of transcripts and field notes were conducted using ATLAS.ti.

Results: Participants were largely unaware of PHRs; nevertheless, many expressed views highly in favor of its use with sexual partners. Perceived benefits included, convenience, reducing conversation awkwardness, and information verification. Information security vulnerabilities, partner distrust implications and unprotected sex enablement were perceived as risks. Perceptions of PHR use were highly contextual and appear to be influenced by factors on individual, dyadic/relational, social environment and structural levels.

Discussion: Findings suggest that prevention conversations facilitated with PHRs may be widely but not universally adopted. The practice was perceived as beneficial to sexual health; however, it was also perceived to potentially increase risk when used as a proxy for determining condom use. Addressing PHR awareness and access are priority to better determining its preventative value in this population.