Advancing HIV Prevention and Linkage to Care Among MSM with Gamification

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 DESCRIPTION (provided by applicant): A public health emergency is threatening young men who have sex with men (MSM), a group who experienced an alarming 22% increase in new HIV infections from 2008 to 2010. New and innovative strategies for HIV prevention are urgently needed among this high-risk group. The goal of the proposed study is to develop and pilot I Got Your Back, a intervention to increase the uptake of HIV and sexually transmitted infection (STI) prevention and care services by young MSM in the San Francisco Bay Area and Los Angeles. The intervention uses the novel approach of gamification, the use of game elements in non-game contexts, to increase the demand for HIV/STI screening and to encourage safer sexual behaviors. The motivation for the study is a growing body of evidence suggesting that financial incentives can increase the uptake of HIV prevention and care services. However, despite their benefits, financial incentives aren't always effective, they may be costly, and they typically lack durable impact. Several studies have demonstrated that modifying incentive-based programs by incorporating elements of games - an approach known as gamification - can be more effective and cost-effective than simple financial incentives alone. In addition, psychological theory and evidence from the field of health behavior suggests that programs including game-like elements may be more sustainable. However, despite its potential to enhance what we know about incentives, gamification is a largely unexplored strategy to improve the health of young MSM. We will develop and pilot I Got Your Back, a prevention intervention for young high-risk MSM that uses gamification. The intervention includes the game elements of rewards (financial and non-financial prizes and lotteries) earned by accumulating points awarded for participants' individual and group engagement in various activities (i.e., peer recruitment, initial and repeat HIV/STI screening, social support), with participants' rankings displayed on an online leaderboard. We will first develop and operationalize game elements for the intervention (Aim 1), and then we will conduct a pilot study among 120 high-risk MSM aged >18-26< years of age to determine whether the intervention is successful at encouraging young MSM to be regularly screened for HIV and other STIs and to adopt safer sexual behaviors (Aim 2). A mixed-methods process evaluation (Aim 3) will determine whether a future effectiveness study to examine the effects of the intervention on HIV/STI incidence is warranted. The research team is a collaboration between the University of California, Berkeley, AIDS Healthcare Foundation (AHF) and the University of California, Los Angeles. The proposed study will explore, for the first time, the effect of gamification on enhancing services along the HIV care continuum. The results from the study will provide guidance about whether this novel approach has the potential to reduce high-risk behavior and decrease the incidence of HIV/STIs among young MSM.