A Digital Intervention for HIV Prevention in Black Adolescent Girls

项目总结 黑人女性被诊断出感染人类免疫缺陷病毒(HIV)的比例不成比例， 传播感染(STI)。黑人妇女经常通过高危性行为感染艾滋病毒/性传播疾病，而青春期是 当这些行为更常见的时候。此外，黑人少女更容易受到艾滋病毒/性传播感染的影响。 与青春期女孩的其他人口统计数字相比；然而，几乎没有设计出引人入胜和有效的干预措施 专门为他们准备的。事实上，许多人并不知道他们的伴侣艾滋病毒/性传播感染状况，也没有持续使用 避孕套是为了保护自己。因此，通过以下方式对抗个人层面风险认知的干预措施 促进对自己及其伴侣进行艾滋病毒/性传播感染检测，减少危险行为，如不使用避孕套 使用，是非常需要的。有令人信服的证据表明，同龄人在保护 与艾滋病毒/性传播感染相关的风险，提供交流知识、影响态度和 培养新的行为技能。经常与其他人一起玩的视频游戏干预可以是 在文化上量身定做，提供行为技能培训，并在影响健康方面表现出有效性 与健康促进相关的行为。随着越来越多的证据表明视频游戏在改善 健康结果，研究如何利用这些技术来改变黑人的行为是至关重要的 青春期的女孩。在耶鲁大学妇女健康研究试点项目的资助下，耶鲁大学的 Play2PreveNT实验室开发并试点测试了一款基于理论的社交纸牌游戏干预，One Night STAN，旨在增加18岁年轻黑人女性的伴侣艾滋病毒/性传播感染检测和避孕套使用- 24.对21名年龄在18-21岁的黑人女性进行的初步研究结果表明，玩 游戏可以增加自我效能感和使用避孕套的意图，并坚持让他们的伴侣接受检测 艾滋病病毒的时间跨度。在游戏满意度方面，100%的参与者表示他们会玩 再次玩游戏，95%的人喜欢游戏的外观，100%的人喜欢玩游戏，100%的人报告说 他们会让他们的朋友一起玩。这项研究的结果表明，One Night Stan是一种可行的 干预方法，并可能有效地帮助球员发展认知和动机模式 这可以保护他们免受艾滋病毒感染的风险。一个由耶鲁大学研究中心的专家组成的团队 健康与学习游戏将建立在这项形成性工作和试点数据的基础上，使One Night Stan适应 黑人青春期女孩年轻目标受众的多人视频游戏。对于这项提议，我们将 评价One Night Stan增加自身和伴侣HIV/STI的可行性和初步效果 通过对80名14-18岁的年轻黑人青春期女孩进行试点随机对照试验进行测试。我们 还将探讨干预措施对增加运动员艾滋病毒/性传播感染知识和提高 关于更安全的艾滋病毒/性传播感染做法的意图和态度。作为一款多人视频游戏，这种干预是一种 为经常与同龄人互动并受到同龄人影响的黑人青春期女孩提供了一个引人注目的框架。

PROJECT SUMMARY Black women are disproportionately diagnosed with human immunodeficiency virus (HIV) and sexually transmitted infections (STIs). Black women often contract HIV/STIs through high-risk sex and adolescence is when these behaviors are more common. Furthermore, Black adolescent girls are more affected by HIV/STIs than other demographics of adolescent girls; yet, there are few engaging and effective interventions designed exclusively for them. In fact, many are unaware of their partner HIV/STI status and do not consistently use condoms to protect themselves. Therefore, interventions that counter individual-level risk perception by promoting HIV/STI testing for themselves and their partners and reduce risk behaviors, such as non-condom use, are greatly needed. There is compelling evidence that peers play a significant role in the protection from risk associated with HIV/STIs by providing opportunities to exchange knowledge, influence attitudes, and to develop new behavioral skills. Videogame interventions, which are frequently played with others, can be culturally tailored, provide behavioral skills training, and have demonstrated efficacy in affecting health behaviors related to health promotion. With the growing evidence for the efficacy of videogames in improving health outcomes, it is essential to examine how to harness these technologies to modify behaviors in Black adolescent girls. With funding from the Women’s Health Research at Yale Pilot Program, the Yale’s play2PREVENT Lab developed and pilot tested a theory-based social card game intervention, One Night Stan, which was aimed at increasing partner HIV/STI testing and condom use in young black women aged 18- 24. Preliminary findings of a pilot study conducted with 21 black women aged 18-21 suggest that playing the game can lead to increased self-efficacy and intentions to use condoms and insist that their partners get tested for HIV across time. In terms of gameplay satisfaction, 100% of participants reported that that they would play the game again, 95% liked the way the game looked, 100% enjoyed playing the game, and 100% reported that they would tell their friends to play. Results from this study suggest that One Night Stan is a feasible intervention approach and may be efficacious in helping players develop a pattern of cognitions and motivation that can protect them against the risk of HIV. Together, a team comprised of experts from the Yale Center for Health & Leaning Games will build upon this formative work and pilot data to adapt One Night Stan to a multiplayer videogame for younger target audience of Black adolescent girls. For this proposal, we will evaluate the feasibility and preliminary efficacy of One Night Stan at increasing self and partner HIV/STI testing by conducting a pilot randomized controlled trial with 80 young Black adolescent girls ages 14-18. We will also explore the efficacy of the intervention for increasing players’ HIV/STI knowledge and for increasing intentions and attitudes around safer HIV/STI practices. As a multiplayer videogame, the intervention is a compelling framework for Black adolescent girls who constantly interact and are influenced by their peers.