Abstract
BackgroundAn estimated 50% of adolescents and young adults (AYA) living with HIV are failing to adhere to prescribed antiretroviral treatment (ART). Digital games are effective in chronic disease management; however, research on gaming to improve ART adherence among AYA is limited.ObjectiveWe assessed the feasibility and acceptability of video gaming to improve AYA ART adherence.MethodsFocus group discussions and surveys were administered to health care providers and AYA aged 13 to 24 years living with HIV at a pediatric HIV program in Washington, DC. During focus group discussions, AYA viewed demonstrations of 3 game prototypes linked to portable Wisepill medication dispensers. Content analysis strategies and thematic coding were used to identify adherence themes and gaming acceptance and feasibility. Likert scale and descriptive statistics were used to summarize response frequencies.ResultsProviders (n=10) identified common adherence barriers and strategies, including use of gaming analogies to improve AYA ART adherence. Providers supported exploration of digital gaming as an adherence intervention. In 6 focus group discussions, 12 AYA participants identified disclosure of HIV status and irregular daily schedules as major barriers to ART and use of alarms and pillboxes as reminders. Most AYA were very or somewhat likely to use the demonstrated game prototypes to help with ART adherence and desired challenging, individually tailored, user-friendly games with in-game incentives. Game prototypes were modified accordingly.ConclusionsAYA and their providers supported the use of digital games for ART adherence support. Individualization and in-game incentives were preferable and informed the design of an interactive technology-based adherence intervention among AYA living with HIV.
Highlights
The goals of the US National HIV/AIDS Strategy include increased HIV testing, linkage to care, retention in care, and viral suppression for all persons living with HIV [1]
AYA and their providers supported the use of digital games for antiretroviral treatment (ART) adherence support
Combining Wisepill technology and youths’ interest in digital gaming, we aimed to develop an intervention to link on-time Wisepill openings to in-game incentives to increase ART adherence among AYA living with HIV
Summary
The goals of the US National HIV/AIDS Strategy include increased HIV testing, linkage to care, retention in care, and viral suppression for all persons living with HIV [1]. For an estimated 36,000 adolescents and young adults (AYA) aged 13 to 24 years living with HIV, these are critical goals [2]. Despite the high efficacy of new ART drugs and more available fixed-dose single tablet per day ART regimens, adherence to daily treatment remains suboptimal among AYA; less than half (47%) of youth aged 18 to 24 years living with HIV in 2016 were virologically suppressed [5]. AYA living with HIV are at particular risk of poor adherence due to specific challenges. The development of effective, youth-friendly interventions to improve adherence among AYA living with HIV is critical to improving adherence and treatment outcomes among this population. An estimated 50% of adolescents and young adults (AYA) living with HIV are failing to adhere to prescribed antiretroviral treatment (ART). Digital games are effective in chronic disease management; research on gaming to improve ART adherence among AYA is limited
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