■在过去的几年里,在应用游戏化来促进期望的健康行为方面已经出现了新兴的兴趣。然而,在男男性行为者(MSM)中,这种应用在HIV预防和护理连续体中的有效性知之甚少。
■本研究旨在总结和评估关于游戏化对HIV预防和护理连续体的有效性的研究,包括促进艾滋病毒检测;减少无公寓肛交(CAS);以及摄取和坚持暴露前预防(PrEP),暴露后预防(PEP),和抗逆转录病毒疗法(ART)。
■我们全面搜索了PubMed,Embase,Cochrane图书馆,WebofScience,Scopus,以及《医学互联网研究杂志》及其姊妹期刊,从成立到2024年1月以中英文发表。当他们与活跃或非活跃的对照组一起使用游戏化干预措施并评估以下结果中的至少一种时,纳入了合格的研究:HIV检测;CAS;以及对PrEP的摄取和依从性,PEP,和艺术。在荟萃分析期间,应用了随机效应模型。两名评审员独立评估了每项纳入研究的质量和偏倚风险。
■系统评价确定了26项研究,包括10项随机对照试验(RCTs)。结果表明,游戏化的数字干预措施已应用于各种艾滋病毒结果,比如艾滋病毒检测,CAS,PrEP摄取和坚持,PEP吸收,艺术坚持。大多数研究在美国进行(n=19,73%)。最常用的游戏组件是获得积分,其次是挑战。荟萃分析显示,游戏化干预可以减少3个月随访时的CAS行为数量(n=2个RCT;发生率比0.62,95%CI0.44-0.88)。荟萃分析还表明,在3个月随访(n=3个RCT;风险比1.16,95%CI0.96-1.38)和6个月随访(n=4个RCT;风险比1.28,95%CI0.89-1.84)时,PrEP依从性有效但无统计学意义。仅设计了1个试点RCT来评估游戏化应用程序在促进HIV检测和PrEP吸收方面的有效性。没有进行RCT来评估游戏化数字干预对PEP摄取和依从性的影响。MSM之间的ART启动。
■我们的研究结果表明,游戏化数字干预对降低MSM中CAS行为数量的短期影响。仍然需要进一步的有力研究来评估游戏化数字干预对HIV检测的影响,PrEP摄取,PEP启动和遵守,和ART启动在MSM。
UNASSIGNED: In the past few years, a burgeoning interest has emerged in applying
gamification to promote desired health behaviors. However, little is known about the effectiveness of such applications in the HIV prevention and care continuum among men who have sex with men (MSM).
UNASSIGNED: This study aims to summarize and evaluate research on the effectiveness of
gamification on the HIV prevention and care continuum, including HIV-testing promotion; condomless anal sex (CAS) reduction; and uptake of and adherence to pre-exposure prophylaxis (PrEP), postexposure prophylaxis (PEP), and antiretroviral therapy (ART).
UNASSIGNED: We comprehensively searched PubMed, Embase, the Cochrane Library, Web of Science, Scopus, and the Journal of Medical Internet Research and its sister journals for studies published in English and Chinese from inception to January 2024. Eligible studies were included when they used gamified interventions with an active or inactive control group and assessed at least one of the following outcomes: HIV testing; CAS; and uptake of and adherence to PrEP, PEP, and ART. During the meta-analysis, a random-effects model was applied. Two reviewers independently assessed the quality and risk of bias of each included study.
UNASSIGNED: The systematic review identified 26 studies, including 10 randomized controlled trials (RCTs). The results indicated that gamified digital interventions had been applied to various HIV outcomes, such as HIV testing, CAS, PrEP uptake and adherence, PEP uptake, and ART adherence. Most of the studies were conducted in the United States (n=19, 73%). The most frequently used game component was gaining points, followed by challenges. The meta-analysis showed
gamification interventions could reduce the number of CAS acts at the 3-month follow-up (n=2 RCTs; incidence rate ratio 0.62, 95% CI 0.44-0.88). The meta-analysis also suggested an effective but nonstatistically significant effect of PrEP adherence at the 3-month follow-up (n=3 RCTs; risk ratio 1.16, 95% CI 0.96-1.38) and 6-month follow-up (n=4 RCTs; risk ratio 1.28, 95% CI 0.89-1.84). Only 1 pilot RCT was designed to evaluate the effectiveness of a gamified app in promoting HIV testing and PrEP uptake. No RCT was conducted to evaluate the effect of the gamified digital intervention on PEP uptake and adherence, and ART initiation among MSM.
UNASSIGNED: Our findings suggest the short-term effect of gamified digital interventions on lowering the number of CAS acts in MSM. Further well-powered studies are still needed to evaluate the effect of the gamified digital intervention on HIV testing, PrEP uptake, PEP initiation and adherence, and ART initiation in MSM.