Skip to main content
Top
Published in:

22-05-2023 | Human Immunodeficiency Virus

A Review of Serious Gaming as an Intervention for HIV Prevention

Authors: Ariel U. Smith, Gabriella M. Khawly, Janna Jann, Ana Paola Mata Zetina, Janeth Padilla, Rebecca Schnall

Published in: Current HIV/AIDS Reports | Issue 4/2023

Login to get access

Abstract

Purposeof Review

Young people face the highest number of new HIV infections globally. With today’s increasing access to smartphones, serious games have been viewed as an effective means of improving knowledge and behavioral outcomes. This systematic review describes current HIV prevention serious games and their relationship with HIV-related knowledge and behavioral outcomes.

Recent Findings

A search of HIV prevention serious games was conducted using PubMed, CINAL, IEEE, Web of Science, and Google Scholar. A total of 31 papers were identified, which consist of 20 studies and 11 protocols. Results for knowledge, attitudes, intentions, and behaviors were mixed. Two interventions reported improvement in PrEP usage and optimal dosing.

Summary

Gaming appears to be a viable and engaging method to improve knowledge, attitudes, and behavioral outcomes to promote HIV prevention among diverse groups of adolescents and young adults globally. However, additional research is needed to understand how to implement this modality effectively.
Literature
3.
go back to reference Smith LR, Patel VV, Tsai AC, Mittal ML, Quinn K, Earnshaw VA, Poteat T. Integrating intersectional and syndemic frameworks for ending the US HIV epidemic. Am J Public Health. 2022;112(S4):S340–3.CrossRefPubMedPubMedCentral Smith LR, Patel VV, Tsai AC, Mittal ML, Quinn K, Earnshaw VA, Poteat T. Integrating intersectional and syndemic frameworks for ending the US HIV epidemic. Am J Public Health. 2022;112(S4):S340–3.CrossRefPubMedPubMedCentral
4.
go back to reference Aidala AA, Wilson MG, Shubert V, Gogolishvili D, Globerman J, Rueda S, Rourke SB. Housing status, medical care, and health outcomes among people living with HIV/AIDS a systematic review. Am J Public Health. 2016;106(1):e1–23.CrossRefPubMedPubMedCentral Aidala AA, Wilson MG, Shubert V, Gogolishvili D, Globerman J, Rueda S, Rourke SB. Housing status, medical care, and health outcomes among people living with HIV/AIDS a systematic review. Am J Public Health. 2016;106(1):e1–23.CrossRefPubMedPubMedCentral
5.
go back to reference • Ferrari M, Mcllwaine SV, Reynolds JA, Archie S, Boydell K, Lal S, Shah JL, Henderson J, Alvarez-Jimenez M, Andersson, Boruff J, Lundedal Nielsen RK, Lyer SN. Digital game interventions for youth mental health services (gaming my way to recovery): protocol for a scoping review. JMIR Res Protoc. 2020; https://doi.org/10.2196/13834. This study shows the value of digital gaming interventions for mental health. • Ferrari M, Mcllwaine SV, Reynolds JA, Archie S, Boydell K, Lal S, Shah JL, Henderson J, Alvarez-Jimenez M, Andersson, Boruff J, Lundedal Nielsen RK, Lyer SN. Digital game interventions for youth mental health services (gaming my way to recovery): protocol for a scoping review. JMIR Res Protoc. 2020; https://​doi.​org/​10.​2196/​13834. This study shows the value of digital gaming interventions for mental health.
6.
go back to reference Walther BK. Playing and gaming. Game studies. 2003;3(1):1–20. Walther BK. Playing and gaming. Game studies. 2003;3(1):1–20.
8.
go back to reference Karagiorgas DN, Niemann S. Gamification and game-based learning. J Educ Technol Syst. 2017;45(4):499–519.CrossRef Karagiorgas DN, Niemann S. Gamification and game-based learning. J Educ Technol Syst. 2017;45(4):499–519.CrossRef
9.
go back to reference Caserman P, Hoffmann K, Müller P, Schaub M, Straßburg K, Wiemeyer J, Bruder R, Göbel S. Quality criteria for serious games: serious part, game part, and balance. JMIR serious games. 2020;8(3):e19037.CrossRefPubMedPubMedCentral Caserman P, Hoffmann K, Müller P, Schaub M, Straßburg K, Wiemeyer J, Bruder R, Göbel S. Quality criteria for serious games: serious part, game part, and balance. JMIR serious games. 2020;8(3):e19037.CrossRefPubMedPubMedCentral
10.
go back to reference Deterding, Sebastian, et al. From game design elements to gamefulness: defining gamification. Proceedings of the 15th international academic MindTrek conference: Envisioning future media environments. 2011. Deterding, Sebastian, et al. From game design elements to gamefulness: defining gamification. Proceedings of the 15th international academic MindTrek conference: Envisioning future media environments. 2011.
11.
go back to reference Krath, Jeanine, Linda Schürmann, and Harald FO Von Korflesch. Revealing the theoretical basis of gamification: a systematic review and analysis of theory in research on gamification, serious games and game-based learning. Comp Human Behav 125 (2021): 106963 Krath, Jeanine, Linda Schürmann, and Harald FO Von Korflesch. Revealing the theoretical basis of gamification: a systematic review and analysis of theory in research on gamification, serious games and game-based learning. Comp Human Behav 125 (2021): 106963
12.
go back to reference Naslund John A, et al. Emerging mHealth and eHealth interventions for serious mental illness a review of the literature. J Mental Health. 2015;24(5):321–32.CrossRef Naslund John A, et al. Emerging mHealth and eHealth interventions for serious mental illness a review of the literature. J Mental Health. 2015;24(5):321–32.CrossRef
17.
go back to reference • Ferrari M, Mcllwaine SV, Reynolds JA, Archie S, Boydell K, Lal S, Shah JL, Henderson J, Alvarez-Jimenez M, Andersson, Boruff J, Lundedal Nielsen RK, Lyer SN. Digital game interventions for youth mental health services (gaming my way to recovery): protocol for a scoping review. JMIR Res Protoc. 2020; https://doi.org/10.2196/13834. This study shows the value of digital gaming interventions for mental health. • Ferrari M, Mcllwaine SV, Reynolds JA, Archie S, Boydell K, Lal S, Shah JL, Henderson J, Alvarez-Jimenez M, Andersson, Boruff J, Lundedal Nielsen RK, Lyer SN. Digital game interventions for youth mental health services (gaming my way to recovery): protocol for a scoping review. JMIR Res Protoc. 2020; https://​doi.​org/​10.​2196/​13834. This study shows the value of digital gaming interventions for mental health.
19.
go back to reference ••Hightow-Weidman L, Muessig K, Knudtson K, Srivatsa M, Lawrence E, LeGrand S, Hotten A, Hosek S. A gamified smartphone app to support engagement in care and medication adherence for HIV-positive young men who have sex with men (AllyQuest): development and pilot study. JMIR Public Health Surveill. 2018; https://doi.org/10.2196/publichealth.8923(This study compiles and compares various in-person and digital HIV interventions.) ••Hightow-Weidman L, Muessig K, Knudtson K, Srivatsa M, Lawrence E, LeGrand S, Hotten A, Hosek S. A gamified smartphone app to support engagement in care and medication adherence for HIV-positive young men who have sex with men (AllyQuest): development and pilot study. JMIR Public Health Surveill. 2018; https://​doi.​org/​10.​2196/​publichealth.​8923(This study compiles and compares various in-person and digital HIV interventions.)
23.
go back to reference Collins PY, Velloza J, Concepcion T, Oseso L, Chwastiak L, Kemp CG, Wagenaar BH. Intervening for HIV prevention and mental health: a review of global literature. J Int AIDS Soc. 2021;24:e25710.CrossRefPubMedPubMedCentral Collins PY, Velloza J, Concepcion T, Oseso L, Chwastiak L, Kemp CG, Wagenaar BH. Intervening for HIV prevention and mental health: a review of global literature. J Int AIDS Soc. 2021;24:e25710.CrossRefPubMedPubMedCentral
24.
go back to reference Kimmel AD, Martin EG, Galadima H, Bono RS, Tehrani AB, Cyrus JW, Krist AH. Clinical outcomes of HIV care delivery models in the US: a systematic review. AIDS care. 2016;28(10):1215–22.CrossRefPubMedPubMedCentral Kimmel AD, Martin EG, Galadima H, Bono RS, Tehrani AB, Cyrus JW, Krist AH. Clinical outcomes of HIV care delivery models in the US: a systematic review. AIDS care. 2016;28(10):1215–22.CrossRefPubMedPubMedCentral
25.
go back to reference Garrard J. The Matrix Method. 5th ed. Minneapolis: Jones & Bartlett Learning; 2017. Garrard J. The Matrix Method. 5th ed. Minneapolis: Jones & Bartlett Learning; 2017.
26.
go back to reference •• Fiellin LE, Kyriakides TC, Hieftje KD, Pendergrass TM, Duncan LR, Dziura JD, Sawyer BG, Fiellin DA. The design and implementation of a randomized controlled trial of a risk reduction and human immunodeficiency virus prevention video game intervention in minority adolescents: PlayForward: Elm City Stories. Clin Trials. 2016. https://doi.org/10.1177/1740774516637871. Playforward trial showed value of HIV video game intervention in minority youth.CrossRefPubMedPubMedCentral •• Fiellin LE, Kyriakides TC, Hieftje KD, Pendergrass TM, Duncan LR, Dziura JD, Sawyer BG, Fiellin DA. The design and implementation of a randomized controlled trial of a risk reduction and human immunodeficiency virus prevention video game intervention in minority adolescents: PlayForward: Elm City Stories. Clin Trials. 2016. https://​doi.​org/​10.​1177/​1740774516637871​. Playforward trial showed value of HIV video game intervention in minority youth.CrossRefPubMedPubMedCentral
28.
go back to reference •• Winskell K, Sabben G, Akelo V, Ondeng’e K, Obong’o C, Stephenson R, Warhol D, Mudhune V. A smartphone game-based intervention (Tumaini) to prevent HIV among young Africans: pilot randomized controlled trial. JMIR Mhealth Uhealth. 2018; https://doi.org/10.2196/10482. Tumaini trial evaluated an effective phone game-based HIV intervention in African adolescents. •• Winskell K, Sabben G, Akelo V, Ondeng’e K, Obong’o C, Stephenson R, Warhol D, Mudhune V. A smartphone game-based intervention (Tumaini) to prevent HIV among young Africans: pilot randomized controlled trial. JMIR Mhealth Uhealth. 2018; https://​doi.​org/​10.​2196/​10482. Tumaini trial evaluated an effective phone game-based HIV intervention in African adolescents.
29.
go back to reference •• Mudhune V, Sabben G, Ondenge K, Mbeda C, Morales M, Lyles RH, Arego J, Ndivo R, Bednarczyk RA, Komro K, Winskell K. The efficacy of a smartphone game to prevent HIV among young Africans: protocol for a randomized controlled trial in the context of COVID-19. JMIR research protocols. 2022;11(3):e35117. https://doi.org/10.2196/35117. This described an HIV gaming intervention.CrossRefPubMedPubMedCentral •• Mudhune V, Sabben G, Ondenge K, Mbeda C, Morales M, Lyles RH, Arego J, Ndivo R, Bednarczyk RA, Komro K, Winskell K. The efficacy of a smartphone game to prevent HIV among young Africans: protocol for a randomized controlled trial in the context of COVID-19. JMIR research protocols. 2022;11(3):e35117. https://​doi.​org/​10.​2196/​35117. This described an HIV gaming intervention.CrossRefPubMedPubMedCentral
30.
31.
go back to reference •• Shegog R, Markham C, Peskin M, Dancel M, Coton C, Tortolero S. “It’s your game”: an innovative multimedia virtual world to prevent HIV/STI and pregnancy in middle school youth. Stud Health Technol Info. 2007;129(Pt 2):983–7. This assessed an HIV gaming intervention. •• Shegog R, Markham C, Peskin M, Dancel M, Coton C, Tortolero S. “It’s your game”: an innovative multimedia virtual world to prevent HIV/STI and pregnancy in middle school youth. Stud Health Technol Info. 2007;129(Pt 2):983–7. This assessed an HIV gaming intervention.
38.
40.
go back to reference •• Schnall R, Kuhns LM, Pearson C, Batey DS, Bruce J, Hidalgo MA, Hirshfield S, Janulis P, Jia H, Radix A, Belkind U, Rodriguez RG, Garofalo R. Efficacy of MyPEEPS mobile, an HIV prevention intervention using mobile technology, on reducing sexual risk among same-sex attracted adolescent males: a randomized clinical trial. JAMA Network Open. 2022;5(9):e2231853. https://doi.org/10.1001/jamanetworkopen.2022.31853. This assessed an HIV gaming intervention.CrossRefPubMedPubMedCentral •• Schnall R, Kuhns LM, Pearson C, Batey DS, Bruce J, Hidalgo MA, Hirshfield S, Janulis P, Jia H, Radix A, Belkind U, Rodriguez RG, Garofalo R. Efficacy of MyPEEPS mobile, an HIV prevention intervention using mobile technology, on reducing sexual risk among same-sex attracted adolescent males: a randomized clinical trial. JAMA Network Open. 2022;5(9):e2231853. https://​doi.​org/​10.​1001/​jamanetworkopen.​2022.​31853. This assessed an HIV gaming intervention.CrossRefPubMedPubMedCentral
43.
go back to reference •• Mustanski B, Garofalo R, Monahan C, Gratzer B, Andrews R. Feasibility, acceptability, and preliminary efficacy of an online HIV prevention program for diverse young men who have sex with men: the keep it up! intervention. AIDS Behav. 2013;17(9):2999–3012. https://doi.org/10.1007/s10461-013-0507-z. This study assessed an HIV gaming intervention.CrossRefPubMed •• Mustanski B, Garofalo R, Monahan C, Gratzer B, Andrews R. Feasibility, acceptability, and preliminary efficacy of an online HIV prevention program for diverse young men who have sex with men: the keep it up! intervention. AIDS Behav. 2013;17(9):2999–3012. https://​doi.​org/​10.​1007/​s10461-013-0507-z. This study assessed an HIV gaming intervention.CrossRefPubMed
45.
go back to reference •• Mustanski B, Madkins K, Greene GJ, Parsons JT, Johnson BA, Sullivan P, Bass M, Abel R. Internet-based HIV prevention with at-home sexually transmitted infection testing for young men having sex with men: study protocol of a randomized controlled trial of Keep It Up! 20. JMIR Research Protocols. 2017;6(1):1. https://doi.org/10.2196/resprot.5740. This study assessed an HIV gaming intervention.CrossRef •• Mustanski B, Madkins K, Greene GJ, Parsons JT, Johnson BA, Sullivan P, Bass M, Abel R. Internet-based HIV prevention with at-home sexually transmitted infection testing for young men having sex with men: study protocol of a randomized controlled trial of Keep It Up! 20. JMIR Research Protocols. 2017;6(1):1. https://​doi.​org/​10.​2196/​resprot.​5740. This study assessed an HIV gaming intervention.CrossRef
46.
go back to reference • Christensen JL, Miller CL, Appleby PR, Corsbie-Massay C, Gustavo GC, Marsella SC, Read SJ. Reducing shame in a game that predicts HIV risk reduction for young adult men who have sex with men: a randomized trial delivered nationally over the web. J Int AIDS Soc. 2013. https://doi.org/10.7448/IAS.16.3.18716. This HIV prevention study allowed men to work on reducing sexual stigma in digital scenarios.CrossRefPubMedPubMedCentral • Christensen JL, Miller CL, Appleby PR, Corsbie-Massay C, Gustavo GC, Marsella SC, Read SJ. Reducing shame in a game that predicts HIV risk reduction for young adult men who have sex with men: a randomized trial delivered nationally over the web. J Int AIDS Soc. 2013. https://​doi.​org/​10.​7448/​IAS.​16.​3.​18716. This HIV prevention study allowed men to work on reducing sexual stigma in digital scenarios.CrossRefPubMedPubMedCentral
47.
go back to reference •• Muessig KE, Baltierra NB, Pike EC, LeGrand S, Hightow-Weidman LB. Achieving HIV risk reduction through HealthMpowermentorg, a user-driven eHealth intervention for young Black men who have sex with men and transgender women who have sex with men. Digit Cult Educ. 2014;6(3):164–82. HealthMpowerment.org trial evaluated an HIV web-based intervention for young Black men.PubMedPubMedCentral •• Muessig KE, Baltierra NB, Pike EC, LeGrand S, Hightow-Weidman LB. Achieving HIV risk reduction through HealthMpowermentorg, a user-driven eHealth intervention for young Black men who have sex with men and transgender women who have sex with men. Digit Cult Educ. 2014;6(3):164–82. HealthMpowerment.org trial evaluated an HIV web-based intervention for young Black men.PubMedPubMedCentral
49.
go back to reference •• Muessig KE, Golinkoff JM, Hightow-Weidman LB, Rochelle AE, Mulawa MI, Hirshfield S, Rosengren AL, Aryal S, Buckner N, Wilson MS, Watson DL, Houang S, Bauermeister JA. Increasing HIV testing and viral suppression via stigma reduction in a social networking mobile health intervention among Black and Latinx young men and transgender women who have sex with men (HealthMpowerment): protocol for a randomized controlled trial. JMIR research protocols. 2020;9(12):e24043. https://doi.org/10.2196/24043. This study assessed an HIV gaming intervention.CrossRefPubMedPubMedCentral •• Muessig KE, Golinkoff JM, Hightow-Weidman LB, Rochelle AE, Mulawa MI, Hirshfield S, Rosengren AL, Aryal S, Buckner N, Wilson MS, Watson DL, Houang S, Bauermeister JA. Increasing HIV testing and viral suppression via stigma reduction in a social networking mobile health intervention among Black and Latinx young men and transgender women who have sex with men (HealthMpowerment): protocol for a randomized controlled trial. JMIR research protocols. 2020;9(12):e24043. https://​doi.​org/​10.​2196/​24043. This study assessed an HIV gaming intervention.CrossRefPubMedPubMedCentral
51.
go back to reference •• Whiteley OE, Mena L, Haubrick K, Craker L, Hershkowitz D, Brown LK. A mobile gaming intervention for persons on pre-exposure prophylaxis: protocol for intervention development and randomized controlled trial. JMIR Research Protocols. 2020;9(9):e18640–e18640. https://doi.org/10.2196/18640. This described an HIV gaming intervention.CrossRefPubMedPubMedCentral •• Whiteley OE, Mena L, Haubrick K, Craker L, Hershkowitz D, Brown LK. A mobile gaming intervention for persons on pre-exposure prophylaxis: protocol for intervention development and randomized controlled trial. JMIR Research Protocols. 2020;9(9):e18640–e18640. https://​doi.​org/​10.​2196/​18640. This described an HIV gaming intervention.CrossRefPubMedPubMedCentral
52.
go back to reference •• Castel WB, Trexler C, D’Angelo LD, Greenberg D. A digital gaming intervention to improve HIV testing for adolescents and young adults: protocol for development and a pilot randomized controlled trial. JMIR Research Protocols. 2021;10(6):e29792–e29792. https://doi.org/10.2196/29792. This described an HIV gaming intervention.CrossRefPubMedPubMedCentral •• Castel WB, Trexler C, D’Angelo LD, Greenberg D. A digital gaming intervention to improve HIV testing for adolescents and young adults: protocol for development and a pilot randomized controlled trial. JMIR Research Protocols. 2021;10(6):e29792–e29792. https://​doi.​org/​10.​2196/​29792. This described an HIV gaming intervention.CrossRefPubMedPubMedCentral
54.
go back to reference •• Rawat S, Wilkerson JM, Lawler SM, Patankar P, Rosser BS, Shukla K, Ekstrand ML. Recommendations for the development of a mobile HIV prevention intervention for men who have sex with men and Hijras in Mumbai: qualitative study. JMIR Public Health Surveillance. 2018;4(2):e9088. This described the development of an HIV gaming intervention.CrossRef •• Rawat S, Wilkerson JM, Lawler SM, Patankar P, Rosser BS, Shukla K, Ekstrand ML. Recommendations for the development of a mobile HIV prevention intervention for men who have sex with men and Hijras in Mumbai: qualitative study. JMIR Public Health Surveillance. 2018;4(2):e9088. This described the development of an HIV gaming intervention.CrossRef
55.
go back to reference •• Lukhele MP, El-Saaidi C, Techasrivichien T, Suguimoto SP, Ono Kihara M, Kihara M. Efficacy of mobile serious games in increasing HIV risk perception in Swaziland: a randomized control trial (SGprev Trial) research protocol. JMIR Research Protocols. 2016;5(4):e224–e224. This described an HIV gaming intervention.CrossRefPubMedPubMedCentral •• Lukhele MP, El-Saaidi C, Techasrivichien T, Suguimoto SP, Ono Kihara M, Kihara M. Efficacy of mobile serious games in increasing HIV risk perception in Swaziland: a randomized control trial (SGprev Trial) research protocol. JMIR Research Protocols. 2016;5(4):e224–e224. This described an HIV gaming intervention.CrossRefPubMedPubMedCentral
56.
go back to reference •• LeGrand S, Knudtson K, Benkeser D, Muessig K, Mcgee A, Sullivan PS, Hightow-Weidman L. Testing the efficacy of a social networking gamification app to improve pre-exposure prophylaxis adherence (P3: Prepared, Protected, emPowered): protocol for a randomized controlled trial. JMIR Research Protocols. 2018;7(12):e10448. https://doi.org/10.2196/10448. This described an HIV gaming intervention.CrossRefPubMedPubMedCentral •• LeGrand S, Knudtson K, Benkeser D, Muessig K, Mcgee A, Sullivan PS, Hightow-Weidman L. Testing the efficacy of a social networking gamification app to improve pre-exposure prophylaxis adherence (P3: Prepared, Protected, emPowered): protocol for a randomized controlled trial. JMIR Research Protocols. 2018;7(12):e10448. https://​doi.​org/​10.​2196/​10448. This described an HIV gaming intervention.CrossRefPubMedPubMedCentral
Metadata
Title
A Review of Serious Gaming as an Intervention for HIV Prevention
Authors
Ariel U. Smith
Gabriella M. Khawly
Janna Jann
Ana Paola Mata Zetina
Janeth Padilla
Rebecca Schnall
Publication date
22-05-2023
Publisher
Springer US
Published in
Current HIV/AIDS Reports / Issue 4/2023
Print ISSN: 1548-3568
Electronic ISSN: 1548-3576
DOI
https://doi.org/10.1007/s11904-023-00659-9

Keynote series | Spotlight on managing health in obesity

Obesity is a major contributor to cardiorenal metabolic disease, but its impact extends throughout the body. Understand how obesity can affect other organ systems and impact treatment, and whether weight-loss measures improve outcomes.

Prof. Eva L. Feldman
Prof. Jonette Keri
Developed by: Springer Medicine
Watch now
Video

Women’s health knowledge hub

Elevate your patient care with our comprehensive, evidence-based medical education on women's health. Designed to help you provide exceptional care for your female patients at every stage of life, we provide expert insights into topics such as reproductive health, menopause, breast cancer and sex-specific health risks and precision medicine.

Read more

Keynote webinar | Spotlight on advances in lupus

  • Live
  • Webinar | 27-05-2025 | 18:00 (CEST)

Systemic lupus erythematosus is a severe autoimmune disease that can cause damage to almost every system of the body. Join this session to learn more about novel biomarkers for diagnosis and monitoring and familiarise yourself with current and emerging targeted therapies.

Join us live: Tuesday 27th May, 18:00-19:15 (CEST)

Prof. Edward Vital
Prof. Ronald F. van Vollenhoven
Developed by: Springer Medicine
Register now
Webinar