The document summarizes a proposed game-based intervention to prevent HIV among young men who have sex with men (MSM) in Mexico City. 22% of MSM in Mexico City are HIV-infected, but only 1/3 know their status. Most get tested late. The intervention aims to use an online game on a gamification platform to increase HIV/AIDS knowledge, promote safe sex, and uptake of HIV/syphilis testing among 18-35 year old MSM. Focus groups with MSM helped develop game elements involving avatars, conversations, and a "sex room" to convey prevention messages subtly. A pilot from July-September 2015 will assess engagement and effects on knowledge, behaviors, and testing.

1. Playing it safe: a game-based intervention to
prevent HIV among young men who have sex
with men in Mexico City
Raluca Buzdugan
Reva Grimball
University of California, Berkeley
April 26-28, 2015
San Francisco, CA
#YTHLive

2. • 22% of MSM in Mexico City are HIV-infected
• Only one third of HIV-infected MSM know their status
• Most HIV-infected MSM start treatment late (50% to
80% of those starting treatment in Mexico City)
• Adequate supply of HIV prevention and treatment
services
• Most MSM are middle-class educated men that use
online applications for networking and dating
HIV epidemic among MSM in Mexico City
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3. To develop and pilot test
an online game embedded within a gamification platform
to incentivize young* MSM in Mexico City to
• learn about HIV/AIDS,
• engage in safe sexual behaviors, and
• get tested for HIV and syphilis
* 18-35 year old
Study objective
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4. #YTHLive
G
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GAME
TRIVIA
INVITE FRIENDS
POINTS
LEADERBOARD
BADGES
HIV & SYPHILIS
TESTING
– confirmed by clinic

5. #YTHLive
Stage 1: DEVELOPMENT OF INTERVENTION
- 6 focus group discussions with MSM
Stage 3: ASSESSMENT OF INTERVENTION:
-> engagement in the intervention
-> effect of the intervention on:
1) knowledge about HIV/AIDS
2) self-reported sexual behaviors
3) uptake of HIV & syphilis testing
-> acceptability of the intervention
o Quantitative: using data collected via the gamification platform, data from clinics
o Qualitative: 20 in-depth interviews with pilot participants
Stage 2: PILOT OF INTERVENTION for 3 months
Recruitment:
a) 10 seeds (via NGO) & their recruits
b) 30 seeds (existing list) & their recruits
Implementation:
Standard intervention
3 variations of the intervention

6. • Objective: develop effective & culturally appropriate
game elements for the intervention
• Methodology: 6 focus groups (39 participants)
– 18-40 year old men from Mexico City who self-identify as MSM
– Separate groups for: 18-25 years olds & 26-35 years olds
 ‘Ideal’ sexual partners, hook-up dialogues and strategies,
scenarios & type of sex acts -> develop & validate profiles for
the game, develop list of sex acts
 Feedback on the platform prototype (avatars, scenarios,
dynamic, dialogues, trivia, the art)
– Discourse analysis using a grounded theory approach
Stage 1: Intervention development
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7. • Playable on smartphones
• Hook: ‘become a better lover’
• Most men don’t want to think/ talk
about HIV
• Players get to choose between two
possible avatars & try to ‘seduce’
and ‘have sex’ with their partners
• Profiles for the avatars & the
partners to ‘connect’ with them
The game – based on focus group info
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8. • Convince the partner to have sex with them
The game – ‘seduction’ stage
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• Conversations:
• Sexy, at times ironic
• Developing a ‘bank of
conversations’ by
involving Mexican
MSM (previous study)
• ‘whatsapp’ chat style
• Interest bar >80% to
enter the ‘sex room’

9. • Player sets the goal: which sex act he hopes to achieve
The game – ‘sex room’ stage
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• Choose a
succession of
actions
• Each action
affects the
pleasure bar
 <15% = lose
 >75% = ask sex
act set as goal

10. • Total number of completed sex acts (number of
‘wins’) – independent of the choices made in sex room
• Player Health score - how the choices made affect the
health of the player’s avatar
• Community Health score - how the player’s choices
affect the health of other members of the community
The game scores
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11. Game & Trivia section
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GAME
Player’s goal: Seduce a virtual
character/ live a sexual fantasy
Information about HIV, STIs, sex
& gay community – unlinked
with the actions in the game
TRIVIA
Player’s goal: Follow the
sex lives of 4 Mexican gay men
- Show possible choices in
risky situations
- ‘Normalize’ HIV
- Ask questions about HIV,
STIs, sex & gay community

12. • Finalize the prototype – May-June 2015
• Pilot the intervention – July-Sep 2015
• Assess the intervention – Oct-Nov 2015
Fundraise to:
• Modify the prototype based on pilot data
• Implement the intervention on a larger scale in Mexico
Next steps
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13. Contact info:
rbuzdugan@berkeley.edu
rgrimba@gmail.com
 INSP (National Institute of Public Health)
Sergio Bautista-Arredondo
Zafiro Andrade-Romo
Laura Chavira-Razo
Gabriel García-Plata
Tania Aramburo Muro
 Engender Games Group Lab - Elena Bertozzi
 Conducttr
 Funding: Grand Challenge Explorations
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