An intervention to increase HIV Testing Uptake among Adolescents and Young Adults

本研究旨在评估使用最先进的社交媒体的可接受性、可用性和有效性 游戏技术可增加 13-24 岁青少年和年轻人 (AYA) 的艾滋病毒检测。费率 AYA 中的 HIV 检测率较低，导致 AYA 中 HIV 检测呈阳性或不知道自己感染 HIV 的比例较高 感染。此外，对老年人有效的公共卫生信息却无法达到同样的效果。 结果为 AYA。由于许多 AYA 高度参与社交媒体和游戏，这些技术可能会 掌握着接触这一人群的关键。虽然之前的行为改变游戏已经取得了积极的成果 通过利用游戏玩法的引人入胜的性质，使健康教育变得有趣，并改变人们对健康教育的态度 疾病预防，这种干预措施建议采用一项新的创新，改变视频的方式 游戏用于增加艾滋病毒检测和与护理的联系。预期的结果是一个新颖的社交媒体 像游戏一样的体验，同时促进有关艾滋病毒风险评估、检测和联系的对话 与传统公共卫生相比，以 AYA 更容易接受的方式进行预防 消息。我们开发了一款基于 AYA 的游戏，玩家可以在其中创建像自己一样的角色 并模拟不同形式的约会和性行为，以了解模拟的、非健康或性行为的后果 危及生命的环境。一旦玩家了解到他们在游戏中承担的与艾滋病毒相关的风险，他们就会 可以识别附近的艾滋病毒检测和预防服务设施。我们试图测试这个游戏的功效 并假设其使用将导致艾滋病毒检测增加并减少危险行为 存在感染艾滋病毒风险的 AYA 人群。在此第二阶段申请中，我们的多学科团队将招募 AYA 协助 通过迭代确定现有原型的额外游戏增强功能的可接受性 焦点小组过程。一旦开发出可接受的原型，我们将对游戏进行试点现场测试 对一小群 AYA 进行干预，以确保可用性、可接受性并进行质量保证 测试。最后，我们将进行一项随机对照试验，以确定干预措施的有效性 HIV 检测的普及率。我们将招募 300 名性活跃的 HIV 阴性 AYA，并将他们随机分为接受 生活模拟游戏干预或提供包含艾滋病毒教育材料的应用程序 和暴露前预防。我们将在 6 点比较两个研究组之间自我报告的 HIV 检测结果。 个月并假设干预组中 AYA 的比例高于对照组 获得艾滋病毒检测。成功完成这些目标将展示该产品如何推动 有效实施基于证据的行为干预措施，以增加艾滋病毒检测并与 青少年的预防性护理。这项核心技术的成功开发也可以修改为 适用于其他医疗状况。

This study aims to assess the acceptability, usability and efficacy of using state-of-the-art social media and game technology to increase HIV testing among adolescents and young adults (AYA) ages 13-24. Rates of HIV testing among AYA are low, resulting in high proportions of AYA who are positive or unaware of their HIV infection. Further, public health messages which can be effective in older adults do not achieve the same results in AYA. Since many AYA are highly engaged with social media and games, these technologies may hold the key to reaching this population. While previous behavior change games have shown positive results by using the compelling nature of gameplay to make health education entertaining and shift attitudes towards disease prevention, this intervention proposes to incorporate a new innovation which changes the way video games are used to increase HIV testing and linkage to care. The intended result is a novel social media experience which plays like a game while prompting dialogue about HIV risk assessment, testing, and linkage to prevention in a manner that may be more acceptable to AYA compared to traditional public health messages. We have developed an AYA-informed game in which players can create characters like themselves and model different forms of dating and sex practices to learn the consequences in a simulated, non-health or life-threatening environment. Once the players learn the HIV-related risks they have taken in the game, they can identify nearby facilities for HIV testing and prevention services. We seek to test the efficacy of this game and hypothesize that its use will result in increased HIV testing and lead to a reduction in risky behaviors among AYA at risk for HIV. In this Phase II application, our multidisciplinary team will recruit AYA to assist in determining the acceptability of additional game enhancements to the existing prototype through an iterative focus group process. Once an acceptable prototype is develop, we will conduct pilot field testing of the game intervention among a small cohort of AYA to ensure usability, acceptability and to conduct quality assurance testing. Finally, we will conduct a randomized controlled trial to determine the efficacy of the intervention on HIV testing uptake. We will enroll 300 sexually active HIV negative AYA and randomize them to receive either the life-simulation game intervention or provision of an app which contains HIV educational materials on HIV and pre-exposure prophylaxis. We will compare self-reported HIV testing between the two study groups at 6 months and hypothesize that a higher proportion of AYA in the intervention versus control group will have obtained HIV testing. Successful completion of these aims will demonstrate how this product may advance the effective implementation of an evidence-based behavioral intervention for increased HIV testing and linkage to preventive care among youth. Successful development of this core technology could also be revised to be applicable to other medical conditions.