A Multilevel Gaming Intervention for Persons on PrEP

 描述（由申请人提供）：使用抗逆转录病毒药物降低获得HIV感染的风险（暴露前预防，PrEP）是一种有效且有前景的新预防策略。在已发表的研究中，PrEP的失败与依从性差和血浆药物水平低有关。这表明最佳的PrEP治疗需要行为干预以促进依从性。避免风险行为的增加对于维持PrEP的保护作用也至关重要。干预措施需要解决正在进行的艾滋病毒风险行为，并与使用PrEP的人（例如年轻的成年MSM）相关。借用最近的艾滋病毒预防和治疗依从性的文献，利用直观的易于使用的技术与激励组件的干预措施显示出行为改变和传播的希望。 本研究将研究一种多层次技术，该技术将药物监测设备（Wisepill分配器）与基于交互式智能手机的应用程序/游戏集成在一起，该应用程序/游戏具有沉浸式和吸引力。这种新颖但直观的多层次技术将测量PrEP依从性，促进治疗和安全性行为的参与。智能手机应用程序/游戏的开发将包括与信息-动机-行为技能（IMB）模型一致的内容。在游戏过程中，参与者将体验吸引人的以行动为导向的冒险，增加有关其健康的信息（例如关于PrEP治疗和艾滋病毒的知识），提高动机（例如行动人物体验坚持的健康益处），并建立技能（例如利用临床医生作为合作伙伴，安全套自我效能）。粘附 来自参与者Wisepill设备的数据将以无线方式集成到应用程序/游戏中，并将在游戏过程中转化为增强功能。对PrEP的年轻人进行深入访谈，并对干预措施进行公开试验，将为干预措施和程序的发展提供信息。在50名PrEP参与者中进行的一项小型随机对照试点研究将检查干预措施的初步疗效（Wisepill分配器与IMB知情应用程序/游戏的整合）。据推测，与对照组的受试者相比，IMB游戏干预的参与者将显示：改善对PrEP的依从性，更高的血液ARV水平，减少HIV风险行为，并改善自我效能和对PrEP治疗依从性的态度。

 DESCRIPTION (provided by applicant): The use of antiretroviral medications to reduce the risk of acquiring HIV infection (Pre-exposure Prophylaxis, PrEP) is an efficacious and promising new prevention strategy. In published studies, failure of PrEP was associated with poor adherence and low plasma drug levels. This indicates that optimal PrEP treatment will require behavioral interventions to promote adherence. Averting increases in risk behavior will also be essential for maintaining PrEP's protective effects. Interventions will need to address on-going HIV risk behavior and be relevant for persons using PrEP (e.g. young adult MSM). Borrowing from recent literature in HIV prevention and treatment adherence, interventions that utilize intuitive easy to use technologies with motivational components show promise for behavior change and dissemination. This study will examine a multi-level technology that integrates a medication monitoring device (Wisepill dispenser) with an interactive smartphone based app/game that is immersive and appealing. This novel, but intuitive multi-level technology will measure PrEP adherence, promote engagement in treatment and safe sexual behavior. The smartphone app/game will be developed to include content consistent with the Information-Motivation-Behavioral Skills (IMB) Model. While gaming, participants will experience absorbing action-oriented adventures that increase information about their health (e.g. knowledge about PrEP treatment and HIV), improve motivation (e.g. action-figures experience health benefits of adherence), and build skills (e.g. utilize clinicians as partners, condom self efficacy). Adherence data from participants' Wisepill device will be integrated into the app/game wirelessly and will translate into enhancements during game play. In-depth interviews with young adults on PrEP and an open trial of the intervention will inform the development of the intervention and procedures. A small randomized controlled pilot study among 50 participants on PrEP will examine the preliminary efficacy of the intervention (integration of the Wisepill dispenser with the IMB informed app/game). It is hypothesized that, compared to subjects in the control group, participants in the IMB Gaming Intervention will show: improved adherence to PrEP, higher blood ARV levels, decreased HIV risk behaviors, and improved self efficacy and attitudes for PrEP treatment adherence.