Efficacy of a Mobile Serious Game (SwaziYolo) for Increasing HIV Risk Perception: Randomized Controlled Trial
Bibliographic record
Abstract
BACKGROUND: Eswatini has one of the highest HIV prevalence rates worldwide (24.8% among people aged ≥15 years), with unprotected heterosexual transmission accounting for more than 90% of new HIV infections in the country. Low HIV risk perception is known to influence risk behavior. Mobile phone technology is growing rapidly, offering opportunities for technology-driven interventions to improve HIV risk perception and prevention. OBJECTIVE: We aimed to design and test a serious game to increase HIV risk perception and intention to engage in protective HIV behaviors among young people in Eswatini. METHODS: Our team developed SwaziYolo, a smartphone-based, interactive, educational story game that places the player in the role of a young adult looking for love in Eswatini's capital city. We conducted the Serious Games HIV Prevention Trial (SGPrev-Trial), a 4-week, 2-arm, unblinded, 1:1 randomized controlled trial of SwaziYolo among people aged between 18 and 29 years in Eswatini. The primary outcome was HIV risk perception using a 10-item and subset 8-item Perceived Risk of HIV Infection Scale (PRHS). We used modified intention-to-treat and per-protocol difference-in-difference (DID) estimation to compare the change between groups in the mean PHRS scores before and after intervention. RESULTS: Of the 380 participants in the study, 122 (64.2%) in the control group and 119 (62.6%) in the intervention group completed the follow-up, and 95 (79.8%) played the game. In the modified intention-to-treat analyses, no significant differences between groups were observed for the 8-item PRHS (DID: mean 1.1, SD 0.72; P=.13) and the 10-item PRHS (DID: mean 1.3, SD 0.80; P=.12) scores. In the per-protocol analyses, HIV risk perception increased significantly among participants who played the game (8-item DID: mean 1.6, SD 0.74; P=.04 and 10-item DID: mean 1.8, SD 0.83; P=.03). Nearly all (94/95, 98.9%) participants strongly agreed or agreed that they would recommend SwaziYolo to their peers. CONCLUSIONS: SwaziYolo was acceptable and increased HIV risk perception among young people in Eswatini who self-selected to play the game. More research is needed to improve and evaluate the SwaziYolo intervention. TRIAL REGISTRATION: UMIN Clinical Trial Registry UMIN000021781; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000025103.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".