Advancing HIV Prevention and Linkage to Care Among MSM with Gamification

 描述（由申请人提供）：公共卫生紧急情况正在威胁与男性发生性关系的年轻男性（MSM），这一群体在2008年至2010年期间经历了令人震惊的22%的新增艾滋病毒感染。在这一高危群体中，迫切需要新的和创新的艾滋病毒预防战略。这项拟议研究的目标是开发和试点“我支持你”，这是一项干预措施，旨在增加旧金山弗朗西斯科湾区和洛杉矶年轻男男性接触者对艾滋病毒和性传播感染（STI）预防和护理服务的接受。该干预措施使用了游戏化的新方法，即在非游戏环境中使用游戏元素，以增加对艾滋病毒/性传播感染筛查的需求，并鼓励更安全的性行为。这项研究的动机是越来越多的证据表明，财政奖励可以增加艾滋病毒预防和护理服务的接受。然而，尽管经济激励措施有好处，但它们并不总是有效的，它们可能成本高昂，而且通常缺乏 持久的影响。几项研究表明，通过融入游戏元素来修改基于激励的计划--一种被称为游戏化的方法--比单纯的经济激励更有效、更划算。此外，心理学理论和健康行为领域的证据表明，包含游戏元素的节目可能更具可持续性。然而，尽管游戏化有可能增强我们对激励措施的了解，但它在很大程度上是一种未被探索的改善年轻男男性接触者健康的策略。我们将开发和试点“我支持你”，这是一项针对年轻高危MSM的预防干预措施，使用游戏化。干预包括通过累积参与者在各种活动中的个人和团体参与所获得的积分而获得的奖励（金融和非金融奖品和彩票）的游戏元素（即，同伴招募、初次和重复艾滋病毒/性传播感染筛查、社会支持），参与者的排名显示在网上排行榜上。我们将首先开发和实施干预的游戏元素（目标1），然后我们将在120名年龄>18-26<岁的高危男男性行为者中进行试点研究，以确定干预是否成功地鼓励年轻男男性行为者定期接受艾滋病毒和其他性传播感染筛查，并采取更安全的性行为（目标2）。混合方法过程评价（目标3）将确定是否有必要在今后进行有效性研究，以审查干预措施对艾滋病毒/性传播感染发病率的影响。该研究小组是由加州大学伯克利分校、艾滋病保健基金会（AHF）和洛杉矶的加州大学合作组成的。这项研究将首次探讨， 游戏化对加强艾滋病毒护理连续体沿着服务的影响。这项研究的结果将为这种新方法是否有可能减少年轻男男性行为者的高危行为和降低艾滋病毒/性传播疾病的发病率提供指导。

 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.