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，以增加13-24岁青少年和年轻人（AYA）的艾滋病毒检测。率 AYA中的艾滋病毒检测率很低，导致AYA中艾滋病毒阳性或不知道其艾滋病毒的比例很高 感染此外，对老年人有效的公共卫生信息并没有达到同样的效果。 结果是AYA。由于许多AYA高度参与社交媒体和游戏，这些技术可能 掌握着接触这些人群的关键虽然以前的行为改变游戏已经显示出积极的效果 利用游戏的吸引力，使健康教育变得有趣， 疾病预防，这项干预措施提出了一项新的创新，改变了视频 游戏被用来增加艾滋病毒检测和与护理的联系。预期的结果是一个新的社交媒体 这是一种游戏体验，同时促进了关于艾滋病毒风险评估、检测和联系的对话。 与传统的公共卫生相比， 充分和传播我们已经开发了一个AYA知情的游戏，玩家可以创建像自己的角色 并模拟不同形式的约会和性行为，以了解模拟的，非健康的或 危及生命的环境。一旦玩家了解了他们在游戏中所承担的与艾滋病毒相关的风险， 可以找到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有效性 并假设它的使用将导致增加艾滋病毒检测，并导致减少危险行为 有艾滋病风险的AYA。在第二阶段的申请中，我们的多学科团队将招募AYA协助 通过迭代来确定对现有原型的附加游戏增强的可接受性， 焦点小组进程。一旦一个可接受的原型是发展，我们将进行试点实地测试的游戏 在一小群AYA中进行干预，以确保可用性、可接受性并进行质量保证 试验.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， 接受艾滋病毒检测。我们将招募300名性活跃的HIV阴性AYA，并将他们随机分配接受以下治疗： 生活模拟游戏干预或提供含有艾滋病毒教育材料的应用程序 和暴露前预防。我们将比较两个研究组之间的自我报告的艾滋病毒检测在6 个月，并假设干预组与对照组相比， 进行艾滋病毒检测。这些目标的成功完成将展示该产品如何推动 有效实施循证行为干预措施，增加艾滋病毒检测， 青年人的预防保健。这一核心技术的成功开发也可以修改为 适用于其他医疗条件。

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.