Over a million people in the United States are infected with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), with one out of five unaware of their infection status1. Although the overall number of new infections has remained relatively stable over the past 4 years, the HIV incidence in people aged 13-29 has increased by 21%2. African Americans are among the groups most affected. Even though African Americans represent only 14% of the population in the United States, they accounted for 44% (21,200) of all new HIV infections in 2009. Among youth, minorities and girls are groups that have been particularly hard hit by HIV/AIDS. They represented 61% of HIV/AIDS cases among 13- to 24-year olds. Additionally, only 19% of teens ages 15 to 19 reported that they have ever been tested for HIV3. The situation in the District of Columbia (DC) is at epidemic levels with four percent of African-Americans living in DC infected with HIV/AIDS4. In this study, our research team proposes to develop an age, gender, and culturally-relevant, mobile- based prototype of SAAFE incorporating input from African American adolescents. The 9-month study includes focus group, paper mockup, mobile application design, development and pilot testing of the SAAFE game at one pilot site in the District of Columbia. The research builds upon prior work in mobile development, usability design, and public health from our team. Our team includes expertise in developmental psychology and developmental science, sexual health, maternal and child health, public policy, community based participatory research, quantitative and qualitative methodology, and mobile development. The long-term product goal is to develop the SAAFE product to be user-friendly, culturally-relevant cross- platform application available on various mobile devices for HIV prevention interventions for urban minority adolescents and how to improve positive sexual health beliefs and practices. If successful, the study will have significant impact in informing health care practitioners on leveraging theory-driven, evidence-based gaming approach for improving health outcomes in HIV prevention intervention.
SAAFE is a theory-driven, evidence-based, and culturally-relevant mobile game with innovative game features offers a cost-effective approach to promoting adoption of healthy sexual behaviors in adolescents. It is designed to (1) improve adolescents'perceptions of sexual health risks;(2) increase adolescents'motivation to adopt specific protective factors (namely, use a condom, practice abstinence, partner with others who have more positive sexual and reproductive health practices, and get testing for STIs and HIV);and (3) increase adolescents'adoption of specific protective sexual health practices.