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

艾滋病毒是菲律宾的一个重大健康问题。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/艾滋病感染者。86%的艾滋病毒阳性人群是男男性行为者（MSM），其中36%与女性发生异性恋活动。目前的诊断系统存在两个主要问题。根据PDOH的观察，高风险人群倾向于不主动进行检测，在目前的系统中，检测和诊断之间的两周时间间隔导致治疗和护理的回报很少。这和其他几个因素导致菲律宾成为世界上艾滋病毒流行增长最快的国家。显然需要解决当前的诊断系统并实施有针对性的干预措施。由于青少年在难以接触的高风险群体中占很大比例，该项目旨在：通过数字游戏干预改善寻求治疗的行为和依从性；并通过快速诊断检测提高检测的可及性和诊断速度。该研究将在艾滋病毒感染率为5.3-6.7%的马尼拉大都会进行。将包括马尼拉大都会地区的两个干预诊所和4个控制诊所。将采用阶梯楔形研究设计进行游戏评估。目前用于艾滋病毒检测和咨询（HTC）的基于实验室的ELISA和western blot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个月后逐步引入游戏，为两种干预提供三种评估：当前实践，仅RDA和RDA与游戏干预相结合。试点研究将表明，与控制机构相比，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动机因素。这将为可能在全国扩大干预措施提供有价值的信息。总部设在英国的研究小组将提供专门知识和指导，确保向菲律宾转移技能和知识，以规划、加强艾滋病毒卫生系统内的能力、推出、监测和评估拟议的两种干预措施的价值。

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.