Pilot project tests gamification as a tool to help prevent HIV infection in young gay men in Oakland and Los Angeles

November 16, 2015

Man holding tabletHarnessing the UC Berkeley School of Public Health’s strengths in adolescent health and technological solutions, a research team lead by Assistant Professor Sandra McCoy will develop, implement, and evaluate a novel intervention to improve HIV and sexually transmitted disease prevention among young gay men in Oakland and Los Angeles (Hollywood). The two-year pilot project, a collaboration between UC Berkeley, UCLA, and the AIDS Healthcare Foundation, has been recently funded by a grant from the National Institute of Health.

While the estimated incidence of HIV has remained stable overall in recent years in the United States, young men who have sex with men (MSM), aged 13–24, are an unfortunate exception. From 2008 to 2010 this group experienced a significant 22 percent increase in new HIV infections. McCoy and School of Public Health researcher Raluca Buzdugan believe that gamification—the use of game elements such as a points system, badges, and financial and non-financial prizes in non-game contexts—could be an effective way to address this public health emergency.

Their program, I Got Your Back, incorporates gamification to increase the incentive for young MSM to take advantage of existing HIV and STD prevention services like routine screenings, risk reduction counseling, and the promotion of safe sex.

“We already have all these effective prevention services and tools available, but we want to increase the demand for them and their utilization,” says McCoy. “It’s not a replacement; it’s a way to enhance the use among this higher risk population.”

I Got Your Back will include the game elements of rewards (financial and non-financial prizes and lotteries) earned by accumulating points awarded for participants’ individual and group engagement in various activities (i.e., peer recruitment, initial and repeat HIV/STD screening, social support), with participants’ rankings displayed on an online leaderboard. The intervention will incorporate competition and collaboration without jeopardizing the confidentiality of the patients.

Several studies have demonstrated that modifying incentive-based programs with game elements can be more effective and cost-effective than simple financial incentives alone. But gamification has predominantly been used for the delivery of health services for chronic diseases like diabetes and asthma, says McCoy. It is a largely unexplored strategy to improve the health of young MSM.

“If we can create something that is truly interesting for the targeted population, we should be able to shift the balance of motivation for them,” says Buzdugan, who is also working on a similar project in Mexico, in collaboration with Sergio Bautista-Arrendondo of the National Institute of Public Health in Mexico.

For the first year of the grant, the team will develop and operationalize the game elements for the intervention. In the second year, they will conduct a pilot study among 120 high-risk MSM aged 18-26 in Oakland and Los Angeles.

“We want to do something from the ground up that is responsive to the needs, likes, and preferences of the men in Hollywood and Oakland,” says McCoy. “But our hope for the future is to create something that is applicable to a wide variety of settings.”

The team will also conduct a mixed-methods process evaluation to determine whether a future effectiveness study is warranted. 

“Part of the process is to figure out the longevity of the intervention’s use,” says Buzdugan. “Maybe the goal is not to sustain the intervention, but only to create a link between the men and the health services. This is something that we need to figure along the way as part of the learning process.”

The UC Berkeley project team also includes Nancy Padian, adjunct professor of epidemiology, and Dan Acland, assistant adjunct professor of public policy.

By Jasmin M. Huynh