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UT School of Public Health researchers develop game for HIV+ youth

June 24, 2009

Researchers at The University of Texas School of Public Health have developed a game for HIV-positive youth, +CLICK, designed to reduce secondary transmission of the virus.

+CLICK was developed by Christine Markham, Ph.D., and Ross Shegog, Ph.D., assistant professors of behavioral sciences. The game's usability and credibility were assessed by HIV-positive (HIV+) youth at a Texas Children's Hospital clinic. Results from the study were published in the May issue of AIDS Care.




According to the World Health Organization, adolescents and young adults ages 13-24 account for 40 percent of new HIV infections worldwide and almost half of all HIV infections in the United States. Many HIV+ youth engage in risky sexual behaviors, according to Markham.

"We wanted to create +CLICK so that we could help educate youth on the importance of making proper, healthy decisions to protect their relationships and themselves as well as help to reduce transmission of the HIV virus," said Markham, lead investigator of the study.

The game was developed as an adjunct to the youths' traditional clinic-based self-management education.

The small sample size of 32 study participants included 62.5 percent females and 37.5 percent males. Of those participants, 56.2 percent contracted the virus through birth and 43.8 percent became infected through sexual contact.

Markham and Shegog worked with Mary Paul, M.D., associate professor of pediatrics at Baylor College of Medicine, and Amy Leonard, M.P.H., research coordinator at Baylor College of Medicine, to develop the material presented in the interactive lessons.

Replicating a shopping mall, study participants travel through lessons on abstinence, condoms and contraception, and also watch video clips from experts and peers who are also HIV+. +CLICK is designed to target four behaviors: choosing not to have sex; disclosing HIV status to a potential partner; using condoms correctly and consistently; and using an effective method of birth control along with condoms.

Participants were able to play several of the game's lessons in approximately 15 minutes during their regularly scheduled clinic visits. "Participants were very receptive and enthusiastic about playing the game," said Leonard. "They also liked that they were able to ask the clinicians questions about what they learned on the lessons." Credibility of the game was trusted by 93.8 percent of the participants and 84.4 percent of users found the game to be very easy to use and would tell others about +CLICK, according to the study.

A prototype of the game was used for the study. The game, which is in the last stages of development, is tentatively scheduled to be available to the public in approximately six months. In addition, the research team is working to create a similar web-based game that will focus on medication adherence for HIV+ youth.

This study was funded by the Baylor College of Medicine-University of Texas at Houston Center for AIDS Research.

The University of Texas School of Public Health



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