利用一款iPhone游戏提升感染艾滋病毒青少年的健康水平。
Enhancing health among youth living with HIV using an iPhone game.
作者信息
Whiteley Laura, Brown Larry K, Mena Leandro, Craker Lacey, Arnold Trisha
机构信息
a Department of Psychiatry and Human Behavior , Alpert Medical School of Brown University , Providence , RI , USA.
b Rhode Island Hospital , Providence , RI , USA.
出版信息
AIDS Care. 2018;30(sup4):21-33. doi: 10.1080/09540121.2018.1503224. Epub 2019 Jan 9.
BACKGROUND
Despite promising outcomes of antiretroviral therapy (ART), challenges to improving adherence among youth living with HIV (YLWH) exist. Mobile games are popular among youth and may improve skills related to resilience, coping, and ART adherence. This study examines the preliminary effects of an iPhone game/app on ART adherence, viral load, and relevant knowledge and attitudes among YLWH in Jackson, MS.
METHODS
A RCT with 61 YLWH tested the impact of BattleViro, an ART-related iPhone game, over 16 weeks. Participants, ages 14-26, were recruited from HIV clinics and randomly assigned to receive BattleViro or a non-HIV-related game. All participants received a medication monitoring device. Chi-square and t-test analyses examined baseline differences between conditions. Continuous outcomes were examined using analyses of covariance (ANCOVAs) controlling for baseline scores. Cohen's d effect size differences (ESD) between groups were calculated.
RESULTS
The sample was 79% male, 97% Black, and 74% non-heterosexual, with a mean age of 22 years. A third had started ART in the past 3 months. There were no demographic differences between conditions. Examination of ESDs revealed that BattleViro demonstrated promising, but nonsignificant, improvements in HIV knowledge (ESD = 0.50), ART knowledge (ESD = 0.42) and social support (ESD = 0.62). Exploratory moderation analyses revealed interactions between BattleViro and newly starting ART. Those newly starting ART in the BattleViro condition, compared to those in the control, experienced a 0.96 log greater decrease in viral load (ESD=-2.21, F = 4.33, p = 0.04), better adherence (71% vs. 48%; ESD = 1.15, F = 3.90, p = 0.05), more HIV knowledge (ESD = 0.90), and more ART knowledge (ESD = 0.72).
CONCLUSION
BattleViro showed promising improvements in HIV knowledge, ART knowledge and social support. Also, there was improved adherence and viral load outcomes specifically among those newly starting ART. ART initiation may be an opportunity to empower and motivate YLWH to build healthy skills.
背景
尽管抗逆转录病毒疗法（ART）取得了可喜的成果，但提高艾滋病毒感染者（YLWH）的治疗依从性仍面临挑战。手机游戏在年轻人中很受欢迎，可能会提高与恢复力、应对能力和ART依从性相关的技能。本研究考察了一款iPhone游戏/应用程序对密西西比州杰克逊市YLWH的ART依从性、病毒载量以及相关知识和态度的初步影响。
方法
一项随机对照试验（RCT）对61名YLWH进行了为期16周的测试，以检验一款与ART相关的iPhone游戏BattleViro的影响。参与者年龄在14至26岁之间，从艾滋病毒诊所招募，并随机分配接受BattleViro或一款与艾滋病毒无关的游戏。所有参与者都获得了一个药物监测设备。卡方检验和t检验分析了不同组间的基线差异。使用协方差分析（ANCOVA）控制基线分数来检验连续结果。计算了两组之间的科恩d效应量差异（ESD）。
结果
样本中79%为男性，97%为黑人，74%为非异性恋，平均年龄为22岁。三分之一的人在过去3个月内开始接受ART治疗。不同组间在人口统计学上没有差异。对ESD的检查显示，BattleViro在艾滋病毒知识（ESD = 0.50）、ART知识（ESD = 0.42）和社会支持（ESD = 0.62）方面显示出有希望但不显著的改善。探索性调节分析揭示了BattleViro与新开始接受ART治疗之间的相互作用。与对照组相比，在BattleViro组中刚开始接受ART治疗的人病毒载量下降幅度大0.96个对数（ESD = -2.21，F = 4.33，p = 0.04），依从性更好（71%对48%；ESD = 1.15，F = 3.90，p = 0.05），艾滋病毒知识更多（ESD = 更多（ESD = 0.72）。
结论
BattleViro在艾滋病毒知识、ART知识和社会支持方面显示出有希望的改善。此外，特别是在那些刚开始接受ART治疗的人中，依从性和病毒载量结果有所改善。开始接受ART治疗可能是增强和激励YLWH培养健康技能的一个契机。
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