scholarly journals A Digital Gaming Intervention to Improve HIV Testing for Adolescents and Young Adults: Protocol for Intervention Refinement and Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Amanda D. Castel ◽  
Brittany Wilbourn ◽  
Connie Trexler ◽  
Lawrence D. D'Angleo ◽  
Daniel Greenberg
Keyword(s):  
Young Adults ◽  
Hiv Testing ◽  
Hiv Risk ◽  
Real Life ◽  
Risk Profile ◽  
Simulation Game ◽  
Washington Dc ◽  
Pilot Test ◽  
Randomized Controlled ◽  
Gaming Intervention

BACKGROUND Two strategies of the U.S. Ending the HIV Epidemic (EHE) initiative are early diagnosis of infections via widespread testing and prevention of new infections using pre-exposure prophylaxis (PrEP). These strategies are particularly important for adolescents and young adults (AYA) who are disproportionately impacted by HIV, particularly if they identify as Black and/or LGBTQ+. This study will develop and test an interactive life-simulation game in which players can enact real-life behaviors and receive their HIV risk profile to improve HIV testing and PrEP access among AYA ages 13-24 in Washington, DC. OBJECTIVE The goals of this mixed-methods study are to (1) determine the acceptability of an interactive enhanced life-simulation game prototype among AYA, (2) conduct a pilot test of the gaming intervention among a small cohort of AYA to ensure game usability and acceptability, and (3) evaluate the efficacy of an interactive life-simulation game in a randomized controlled study (RCT) with AYA at risk for HIV in Washington, DC. METHODS This research protocol will be conducted in three phases. A formative phase will involve surveys and focus groups (n=64) with AYA living in the DC area. These focus groups will allow researchers to understand youth preferences for game enhancements. The second phase will consist of a pilot test (n=10) of the gaming intervention. This pilot test will allow researchers to modify the game based on formative results and test the planned recruitment and data collection strategy with intended end-users. The third phase will consist of a RCT among 300 AYA to examine the efficacy of the life-simulation game compared with app-based HIV educational materials on HIV and PrEP in changing HIV testing, knowledge, risk behaviors, and PrEP access. Participants will have unlimited access to either the life-simulation game or the educational app for 3 months from the time of enrollment. Study assessments will occur at enrollment and at 1-, 3-, and 6-months post-enrollment via electronic surveys. At 6 months, a subset of intervention participants (n=25) will participate in-depth “exit” interviews regarding their experience being in the study. RESULTS Institutional review board approval was received on February 5, 2020. This project is currently recruiting participants for the formative phase. CONCLUSIONS This interactive life-simulation intervention aims to increase HIV testing and PrEP access among AYA in the DC area. This intervention uses social interactions in which players can enact real-life behaviors and receive their HIV risk profile to promote HIV testing and PrEP seeking. Such an intervention has great potential to improve knowledge of HIV and PrEP among AYA, increase motivation and self-efficacy related to HIV testing and PrEP use, and decrease individual and structural barriers that often preclude engagement in HIV prevention services.

Barriers and Facilitators to HIV Testing among Adolescents and Young Adults in Washington, DC: Formative Research to Inform the Development of an mHealth Intervention (Preprint)

2021 ◽  
Author(s):  
Brittany Wilbourn ◽  
Tyeisa Howard-Howell ◽  
Amanda Castel ◽  
Lawrence D'Angelo ◽  
Connie Trexler ◽  
...  
Keyword(s):  
Young Adults ◽  
Sexual Orientation ◽  
Hiv Testing ◽  
Sexual Behaviors ◽  
Perceived Barriers ◽  
Barriers And Facilitators ◽  
Washington Dc ◽  
Hiv Knowledge ◽  
Mhealth Intervention ◽  
Hiv Epidemic

BACKGROUND Adolescents and young adults (AYA) in the United States (U.S.), and Washington, District of Columbia (DC) specifically, are disproportionately impacted by HIV. Both the U.S. Ending the HIV Epidemic (EHE) initiative and DC-specific plans emphasize HIV testing and innovative strategies are needed. OBJECTIVE The purpose of this study was to identify sexual behaviors, HIV knowledge, HIV perceptions (e.g., susceptibility and severity), and perceived barriers and facilitators to HIV testing among youth at risk for HIV and to identify potential differences based on self-reported sexual orientation. The results from this study were used to inform the development of an mHealth intervention to increase HIV testing among AYA living in Washington, DC. METHODS This study conducted focus groups and surveys stratified by sexual orientation to identify the sociodemographics, sexual behaviors, HIV knowledge, and perceived barriers and facilitators to HIV testing among AYA ages 13-24 in the DC. HIV knowledge was explored during focus groups and measured using an adapted version of the HIV Knowledge Questionnaire. Survey data were summarized using descriptive statistics and compared by self-reported sexual orientation. Transcripts were thematically analyzed. RESULTS A higher proportion of lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth (n=16) reported sexual activity (75% vs. 60%), condomless sex (92% vs. 83%), and HIV testing (81% vs. 58%) than heterosexual youth (n=30, p-values all >0.05). HIV prevention knowledge (“condoms” and “PrEP”) and transmission (“exchange of fluids”) was high and most AYA (77%) perceived HIV testing as beneficial. However, youth also demonstrated some misinformation concerning HIV: Most participants believed an HIV test could deliver accurate results 1-week post potential exposure (67%) and that an HIV vaccine exists (72%). Youth also identified individual (“…people… are scared”) and structural (“…people don’t…know where they can go”) barriers to testing. Most AYA were very likely to use the demonstrated game prototype to help with getting testing for HIV and strongly agreed that the game was interesting, fun, and easy to learn. CONCLUSIONS These results suggest a need for multi-level HIV testing interventions and informed the development of a mHealth intervention aiming to increase HIV knowledge and risk perception among AYA, while reducing barriers to testing at the individual and structural levels, supporting efforts to end the domestic HIV epidemic.

Concerns about contracting HIV, knowing partners’ HIV sero-status and discussion of HIV/STI with sexual partners as determinants of uptake of HIV testing

2018 ◽  
Vol 51 (4) ◽  
pp. 549-561 ◽  
Author(s):  
Anthony Idowu Ajayi ◽  
Abdulazeez Olumide Abioye ◽  
Oladele Vincent Adeniyi ◽  
Wilson Akpan
Keyword(s):  
Young Adults ◽  
Risk Perception ◽  
Hiv Testing ◽  
Hiv Risk ◽  
Sexual Partners ◽  
Adolescents And Young Adults ◽  
Hiv Status ◽  
Open Communication ◽  
Testing Uptake ◽  
Hiv Risk Perception

AbstractWorldwide, adolescents and young adults (aged 15–25 years) account for the highest proportion of new HIV infections, yet the uptake of HIV testing among this cohort is sub-optimal. Understanding factors that predict the uptake of HIV testing among adolescents and young adults is critical for designing effective and relevant interventions to increase testing. Drawing from the psychosocial constructs of the Health Belief Model, the study examined the effects of HIV risk perception, discussion of HIV with partners and knowing partners’ HIV status on HIV testing uptake among adolescents and young adults in two Nigerian universities. The study was conducted in 2018 and was cross-sectional in design, with a final sample of 784 male and female students selected using stratified random sampling. Adjusted and unadjusted logistic regression models were used to examine the effect of HIV risk perception, discussion of HIV with partners and knowing partners’ HIV status on HIV testing uptake. Only 50.6% of participants had ever tested for HIV with 30.7% being tested in the last year, with no significant differences by sex. After controlling for other covariates (age, sex and being sexually active), knowing partners’ HIV status, having discussed HIV with partners and being very concerned about contracting HIV were found to be significantly associated with ever being tested for HIV and recent HIV testing uptake. Uptake of HIV testing was found to be low in the study setting and fell short of the first ‘90%’ UNAIDS target. Age-appropriate strategies, targeting open communication on HIV/STIs and disclosure of sero-status between sexual partners are required to promote uptake of HIV testing among young adults and adolescents in Nigeria.

The Hitman Study

2010 ◽  
Vol 15 (2) ◽  
pp. 99-108 ◽  
Author(s):  
Christopher J. Ferguson ◽  
Stephanie M. Rueda
Keyword(s):  
Experimental Study ◽  
Young Adults ◽  
Aggressive Behavior ◽  
Video Game ◽  
Real Life ◽  
Mood Management ◽  
Video Game Play ◽  
Video Game Playing ◽  
Violent Video Game ◽  
The Social

This article explores commonly discussed theories of violent video game effects: the social learning, mood management, and catharsis hypotheses. An experimental study was carried out to examine violent video game effects. In this study, 103 young adults were given a frustration task and then randomized to play no game, a nonviolent game, a violent game with good versus evil theme (i.e., playing as a good character taking on evil), or a violent game in which they played as a “bad guy.” Results indicated that randomized video game play had no effect on aggressive behavior; real-life violent video game-playing history, however, was predictive of decreased hostile feelings and decreased depression following the frustration task. Results do not support a link between violent video games and aggressive behavior, but do suggest that violent games reduce depression and hostile feelings in players through mood management.

Abuse and HIV Risk Behaviors in Adolescents and Young Adults

1994 ◽  
Author(s):  
R. M. Cunningham ◽  
◽  
A. R. Stiffman ◽  
P. Dore ◽  
F. Earls
Keyword(s):  
Young Adults ◽  
Risk Behaviors ◽  
Hiv Risk ◽  
Hiv Risk Behaviors ◽  
Adolescents And Young Adults

Efficacy and Impact of an mHealth Intervention to promote Mental Wellness for American Indian and Alaska Native Teens and Young Adults: A Randomized Controlled Trial of the BRAVE Study (Preprint)

2020 ◽  
Author(s):  
Stephanie Craig Rushing ◽  
Allyson Kelley ◽  
Sheana Bull ◽  
David Stephens ◽  
Julia Wrobel ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Young Adults ◽  
Alaska Native ◽  
Help Seeking ◽  
Culturally Relevant ◽  
Controlled Trial ◽  
Text Message ◽  
Text Messages ◽  
Randomized Controlled ◽  
Mental Wellness

BACKGROUND Culturally-relevant interventions are needed to help American Indian and Alaska Native (AI/AN) teens and young adults navigate common risky situations involving family and friends, including drug and alcohol misuse, dating violence, and suicidality. We R Native – a multimedia health resource for Native teens and young adults – designed an intervention for Native youth, delivered via text message, that includes role model videos, mental wellness strategies, and links to culturally-relevant resources (hotlines, chat-lines, websites, etc.) and social support. OBJECTIVE This study aims to test the efficacy of BRAVE to improve participant’s physical, mental, and spiritual health, their use of mental wellness strategies, their help-seeking skills, and associated factors, including cultural resilience, identity, and cultural pride. METHODS The randomized controlled trial was carried out by the Northwest Portland Area Indian Health Board and the mHealth Impact Lab. The team recruited 2,334 AI/AN teens and young adults nationwide (15-24 years old) via social media channels and text message and enrolled 1,044 to participate. AI/AN teens and young adults enrolled in the study received either: 8 weeks of BRAVE text messages designed to improve mental health, help-seeking skills, and cultural resilience; or 8 weeks of STEM text messages, designed to elevate and re-affirm Native voices in science, technology, engineering, math and medicine (STEM); and then received the other set of messages. Primary and secondary outcomes were tested using linear mixed-effect models and linear regressions. RESULTS A total of 833 AI/AN teens and young adults were included in the analysis. Individuals in the BRAVE and STEM arms showed significant positive trends over the course of the study for all primary outcomes except cultural identity and help seeking behavior. Mean scores were significantly different for health (P<.001), resilience (P<.001), negative coping (P=.027), positive coping (P<.001), self-efficacy (P=.021), and self-esteem (P<.001). Changes in help-seeking self-efficacy were significant for those exhibiting risky behavior at baseline to exit (P=.01). Those who reported positive coping scores at baseline also reported better health on average, but no difference in risky drug and alcohol use (P<.001). The number of participants that used text messages to help themselves increased from 69% at 3-months (427/618) to 75% at 8-months (381/501) (P<.001). Similarly, the number of participants that used text messages to help a friend or family member increased from 22% at 3-months (138/616) to 55% at 8-months (272/498). CONCLUSIONS This is the first nationwide randomized controlled trial for AI/AN teens and young adults to test the efficacy of an mHealth intervention on mental wellness. The findings suggest that culturally-relevant multimedia, mHealth interventions can improve help-seeking behavior. Lessons learned from this study may help other AI/AN-serving organizations, prevention programs, policymakers, researchers, and educators as they support the next generation of AI/AN change-makers.

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