HIV G.E.T (Gaming, Engaging and Testing) Project

在菲律宾，艾滋病毒是一个重要的健康问题。2015年5月，菲律宾卫生部艾滋病登记处报告了22,684名艾滋病毒/艾滋病患者。86%的HIV+人群是男男性行为者(MSM)，其中36%的人与女性发生异性性行为。目前的诊断系统存在两个主要问题。根据PDOH的观察，高危人群往往不会站出来进行检测，而且在目前的系统中，检测和诊断之间的两周时间段导致治疗和护理的回报很少。这一因素和其他几个因素正导致菲律宾成为世界上艾滋病毒流行增长最快的国家。显然有必要解决目前的诊断系统并进行有针对性的干预。由于青少年在难以接触到的高危人群中占很高比例，该项目寻求：通过数字游戏干预改善求医行为和遵从性；通过快速诊断测试(RDT)改善检测机会和诊断速度。这项研究将在艾滋病毒流行率为5.3-6.7%的马尼拉大都市进行。马尼拉大都会地区的两个干预诊所和4个对照诊所将包括在内。游戏评估将遵循阶梯式楔形研究设计。目前以实验室为基础的艾滋病毒检测和咨询(HTC)的ELISA和Western印迹检测算法将被快速诊断算法(RDA)干预所取代。这将在两个干预诊所推出24个月，并在12个月后分阶段推出游戏，为两种干预措施提供三个方面的评估：当前做法、仅限RDA和RDA与游戏干预相结合。初步研究将表明，与控制设施相比，在干预诊所寻求艾滋病毒服务的人数是否有所增加。它还将使人们更好地了解寻求诊断的动机因素，特别是来自高危人群的因素。这将为可能在全国范围内扩大干预措施提供宝贵的信息。总部设在英国的研究小组将提供专门知识和指导，确保将技能和知识转移到菲律宾，以规划、加强艾滋病毒卫生系统内的能力、推出、监测和评估两项拟议干预措施的价值。

HIV is a significant health issue in the Philippines. In May 2015 the Philippines Department of Health (PDOH) Aids Registry reported 22,684 people living with HIV/AIDS. 86% of the HIV+ population are men who have sex with men (MSM) of which 36% engage in heterosexual activities with women. There are two major issues with the current diagnosis system. According to observations by the PDOH, high risk groups, tend not to come forward for testing, and the two week time period between testing and diagnosis in the current system leads to few returns for treatment and care. This and several other factors are leading to the Philippines having the fastest growing HIV epidemic in the world. There is a clear need to address the current diagnosis system and run targeted interventions.As adolescents make up a high proportion of the hard to reach high risk group, this project seeks to: improve treatment seeking behaviour and compliance through a digital gaming intervention; and improve access to testing and speed of diagnosis through rapid diagnostic tests (RDTs).The study will be undertaken in Metro Manila which has HIV prevalence of 5.3-6.7%. Two intervention clinics in the Metro Manila area and 4 control clinics will be included. A step wedge study design will be followed for game evaluation. The current laboratory-based ELISA and western blot testing algorithm for HIV testing and counselling (HTC), will be replaced by a Rapid Diagnostic Algorithm (RDA) intervention. This will be rolled out for 24 months in 2 intervention clinics and the game introduced after 12 months in a stepped process to provide three arms of evaluation for the two interventions: current practices, RDA only and RDA in combination with gaming intervention.The pilot study will indicate whether the numbers of people seeking HIV services at intervention clinics, compared to control facilities have increased. It will also generate a better understanding of motivational factors for seeking diagnosis, especially from the at risk groups. This will provide valuable information for possible expansion of interventions nationally. The UK-based research team will provide expertise and guidance, ensuring the transfer of skills and knowledge to the Philippines to plan, strengthen capacity within the HIV health system, roll out, monitor and evaluate the value of the two proposed interventions.