Novel Video Game Intervention Promotes HIV Testing in Adolescents

A novel video game intervention may help improve HIV testing and counseling rates among adolescents with HIV infection, according to study results published in the Journal of Adolescent Health. 

The video game Playtest! is a novel web-based intervention designed to promote healthy behaviors and attitudes among adolescents toward HIV testing and counseling. In the game, players learn skills to empower them to make safe choices and are encouraged to advocate for their health.

Researchers conducted a randomized controlled trial between November 2018 and October 2020 to evaluate the effects of this novel video game intervention on behavioral antecedents related to HIV testing and counseling. Eligible participants were enrolled at 5 high schools in Connecticut, aged 14 to 18 years, and had not been tested for HIV infection within the previous year. Participants were randomly assigned 1:1 to either the intervention group or to play video games with no content related to HIV testing and counseling (control). In both groups, participants agreed to play their assigned game once weekly for approximately 1 hour over a period of 4 to 6 weeks.

The initial primary outcome was the number of participants who underwent HIV testing and counseling within a 6-month follow-up period. However, the researchers’ ability to measure this outcome was affected by the COVID-19 pandemic. The revised primary outcome was participants’ attitudes toward HIV testing and counseling, which was measured at 6 months. Secondary outcomes included intentions, knowledge, self-efficacy, and behaviors related to HIV testing and counseling.

Chi-square and t tests were used to eliminate baseline demographic differences between the groups. At 4 time points (baseline, postgame play, 3 months, and 6 months), mixed between-within analysis of variance tests were used to compare the effects of the intervention vs control on the primary outcome.

The final analysis included 287 participants, of whom 145 were assigned to the intervention group and 142 were assigned to the control group. Overall, the mean participant age was 15.4 years, 137 (48.0%) were adolescent girls, and 218 (76.0%) identified as racial or ethnic minorities.

Nearly all participants (range, 94.0%-97.0%) completed follow-up assessments performed between baseline and 6 months. The mean duration of overall game play was 230 and 271 minutes among participants in the intervention and control groups, respectively. 

The researchers noted that most participants (70.0%) in the intervention group showed significant improvement in their attitudes toward HIV testing and counseling (P <.001) during the study period. For participants in the control group, attitudes toward HIV testing and counseling were consistent over time. Participants’ attitudes toward HIV testing and counseling were not significantly affected by age or gender, though mild age-based differences were observed.

Further analysis showed similar findings with respect to secondary outcomes. Participants in the intervention group showed significant improvement in all secondary outcomes, including intentions (P <.001), knowledge (P <.001), and self-efficacy (P =.002). For participants in the control group, secondary outcome measurements remained consistent over the study period.

In regard to HIV testing rates at 6 months, no significant between-group differences were observed (P =.289).

Common reasons to not undergo HIV testing, including “I don’t know where to go” (P <.004); “it costs too much” (P <.001); and “The test might be painful or uncomfortable” (P <.001) were significantly less likely to be reported among intervention vs control group participants.

Limitations of this study include disruptions in follow-up assessments and data retrieval related to the COVID-19 pandemic. 

As an intervention to improve HIV testing and counseling rates, “Playtest! has the potential to have a unique and significant impact on adolescent populations on a national and global level,” the researchers concluded.

Disclosures: One study author declared affiliations with industry. Please see the original reference for a full list of disclosures.

This article originally appeared on Infectious Disease Advisor