ALHIV Smartphone Game Study

A Smartphone Game to Increase Engagement in Care Among African Adolescents Living With HIV

This is a cluster-randomized controlled trial that aims to conduct comprehensive feasibility testing of a smartphone game in a sample of 120 adolescents living with HIV (ALHIV) ages 15-21 in Kisumu, Kenya, to determine whether the game influences behavioral mediators of engagement in care and sexual risk avoidance and reduction (including knowledge, attitudes, behavioral intentions, and self-efficacy).

This is a cluster-randomized feasibility study that will involve clinic-level randomization of 120 ALHIV participants (12 from each of 10 clinical centers). Participants will either use the intervention (a smartphone game) or continue standard treatment and support for HIV. Participants will complete 5 surveys about behaviors, attitudes, knowledge, and self-efficacy relating to engagement in care, ART adherence, and sexual and reproductive health. They will also have blood drawn 3 times to measure their HIV viral load. Intervention-arm participants will also complete app experience surveys. A sample of intervention-arm participants will be invited to provide feedback on their experience in interviews (n=10) and/or focus groups (n=30).

Adolescents, male and female, aged 15-21 in Kisumu County (n=120)

Inclusion criteria:

• Aged 15-21 at time of recruitment
• Diagnosed with HIV and aware of HIV status
• Initiated ART at least 6 months prior
• Accesses HIV-related care at intervention arm CCC
• VL above 50 copies/ml at last test, with last test conducted within 12 months prior to recruitment date

Exclusion criteria

• Does not have basic literacy in English (Grade 3-4 on the Flesch-Kincaid Reading Scale)
• Sibling to an adolescent already enrolled in study
• Sibling to adolescent that participated in formative research
• Participant in formative research to inform study
• Participant in any Tumaini game activities
• Enrolled in boarding school
• Last recorded viral load test >12 months prior to recruitment date