This study will aim to assess the feasibility and acceptability of using state-of-the-art video game technology to increase adherence among HIV+ adolescents and young adults (AYA) ages 13- 24. Treatment fatigue and the desire for increasing independence among this particular population can lead to non-adherence, which can result in treatment-resistant HIV-a critical problem in the field of HIV care. AYA can be hard to reach with conventional health messaging, yet they respond to video games with a high level of engagement. The goal of this project is to harness this strong motivation to play games to improve medication adherence. Previous games for behavior change have shown positive results by using the compelling nature of gameplay to make health education entertaining and to shift attitudes and emotions about the illness and the treatment. This intervention includes all those elements, but goes beyond them with a new innovation which changes the way video games are used for adherence. The intended result is a novel therapeutic which serves as the basis for a marketable product and an effective, evidence-based behavioral intervention that increases adherence to treatment in HIV+ AYA. Our multidisciplinary team will recruit HIV+ AYA to assist in informing the development of prototype smartphone/Web video games. We will develop the intervention with repeated input from the target audience, as well as among their parents and healthcare providers, to increase acceptability. We will conduct feasibility testing and revisions to increase game performance and acceptability. We will pilot an intervention to assess the impact of the games on adherence measures among non-adherent HIV+ AYA over a 6-month period. We will assess the games'acceptability and impact on adherence as measured through biological outcomes such as CD4 count and viral load. We anticipate the results will demonstrate feasibility which will provide data to inform a Phase II study to test the efficacy of the game on increasing adherence through a larger randomized controlled trial as well as provide a more significant level of feedback on playability, art and animation styles, player engagement, and overall acceptability. Successful completion of these aims will demonstrate how this product might advance the effective implementation of an evidence-based behavioral intervention for HIV/AIDS treatment and care among HIV+ youth. The core technology could also be revised to be applied to other medical conditions.

Public Health Relevance

Interactive Technology for Pediatric HIV/AIDS Treatment Adherence is a novel therapeutic designed to significantly improve HIV treatment efficacy in young people by harnessing the uniquely engaging nature of professionally designed, state-of-the-art video games linked to low- cost compliance-confirming devices. Adherence to medical treatment is particularly challenging for young people with any medical condition due to treatment fatigue and their growing need for independence, but rigorous adherence is especially critical for young people living with HIV since poor adherence to antiretroviral treatment can lead to the development of resistant virus and treatment failure. Our goal is to deliver HIV education and behavior change that works with the psychological needs of young people via a daily stream of special in-game incentives designed to motivate a high degree of self-care on a daily basis.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Small Business Innovation Research Grants (SBIR) - Phase I (R43)
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Special Emphasis Panel (ZRG1-AARR-G (10))
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Delcarmen-Wiggins, Rebecca
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Media Rez, LLC
United States
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