Background: Kenya currently has an HIV prevalence rate of 6%, equating to around 1.6 million people living with HIV in the country. Kenya is also one of the six HIV ‘high burden’ countries in Africa. (National Aids Control Council 2014) During the project lifespan, youth aged between 15-24 years were considered “most-at-risk” of contracting the HIV infection by the national HIV/AIDS strategy. In Kenya, young women had an HIV prevalence of 6.1% which was four times higher than their male counterparts. Studies showed knowledge around HIV/AIDS prevention was high amongst youth, however many young people continued to engage in risky behaviours, such as multiple sexual partners and inconsistent condom use.
Developed by Virtual Heroes for Warner Bros Entertainment in partnership with the United States (US) President’s Emergency Plan for AIDS Relief (PEPFAR), Pamoja Mtaani video game was launched in December 2008 in four centres around Nairobi. The goal of the video game was to reach adolescents and young people aged 15-19 years old with behaviour change messages around HIV prevention through the use of a fun and innovative medium.
Target Population: Adolescents and Young People, Rural and Urban, Male and Female, 15-19years.
Technology: To make this five-player, LAN-based PC game experience a reality, Virtual Heroes opted to use Unreal Engine 2.5 in an effort to reach the widest dissemination possible across the available low-resource hardware in Kenyan youth clinics, schools, and other facilities. Click here for full technical details.
Technology Use: The game focused on five key HIV prevention behaviours: delaying first sexual intercourse, abstinence, avoiding multiple partners, correct and consistent condom use, and uptake of voluntary counselling and testing (VCT).
Players assumed the identity of one of five game characters in Pamoja Mtaani: a 22-year-old female musician, an 18-year-old male footballer, a 19-year-old male “techie”, a 21-year-old tout, and a 23-year-old female medical student – as the matatu (commuter bus) they are riding in is carjacked and the passengers are robbed. Played by one, or up to five players, characters set off on a mission to retrieve their stolen items. As a player goes through the different levels of the game they find themselves in situations where they must actively make decisions that will either put them at risk of contracting HIV or help to prevent it. The game uses a combination of behaviour change messaging and more traditional gaming elements such as assignments and side games. Sheng (a mix of English and Swahili used in urban areas) was chosen as the language for the characters and the game’s soundtrack was provided by local hip-hop groups.
Girls were encouraged to play through the use of ’girl only’ time at the gaming centres.
In addition to the game, health services, including STI treatment, peer education sessions, recreational activities, HIV testing and counselling (HTC) 
and other services were offered to youth on the sites where the games were played or through referral. Large-scale community mobilisation drew young people to the sites. CDs containing the video game trailers and music from local artists, The Making of Pamoja Mtaani documentary, t-shirts and other related materials were developed and distributed to raise awareness about HIV and draw youth to the game and available services.
Use of technology generally across urban Kenya was very high and video games appealed to young people. With mobile phone penetration rates of around 90% in Kenya, mobile and videos games had a large potential to provide a cost-effective and entertaining medium to promote behaviour change messaging on HIV prevention.
Organization and Partnerships: Video game developers Virtual Heroes, based in Raleigh, North Carolina, partnered with the President’s Emergency Plan for AIDS Relief (PEPFAR) and Warner Bros. Interactive Entertainment (WBIE) to create Pamoja Mtaani. The President’s Emergency Plan For AIDS Relief (PEPFAR/Emergency Plan) is a United States governmental initiative to address the global HIV/AIDS epidemic and help save the lives of those suffering from the disease, primarily in Africa.
Challenges and Lessons Learned: Pamoja Mtaani video game succeeded in drawing in and retaining young people. Launched in four youth centres, one of the sites attracted over 4,000 young people who played the game between December 2009 to March 2011. While across two different sites an additional 3,472 youth played from May 2010 to March 2011. The game was very popular and well known in Kenya and received high visibility in different TV and radio shows across the continent.
On measuring behaviour change, evaluation results showed that exposure to the video game increased the intention of male players to initiate secondary abstinence, utilize services (STI treatment and VCT) and reduce sex with older partners. Young men also showed increased self-efficacy for condom use while young women’s exposure to the video game increased their intention to delay first sexual intercourse, self-efficacy for reducing concurrent sexual partners and for correct and consistent condom use.
The use of video games can be a key instrument in attracting and retaining young people. However, there is a need to conduct further research and focus on how video games can be used as vehicles for assessment as well as intervention – using education on a variety of topics such as wider sexual reproductive health which is relevant to young people.
Video games tend to attract young men more so than young women with the assumption and stereotype that gaming is for boys. However, in order to reach out to all young people with video games, it’s advisable that young women are engaged in the design process to incorporate some social components that male players may not appreciate or relate to. It is worth noting that young women may tend to prefer narrative games compared to the competitive scenarios which can often be preferred by young men.
This case study was compiled with the following source from Warner Bros Entertainment and assistance from C4D Network member Nicola Harford:
Image source: Screen Shots of Pamoja Mtaani Game https://www.youtube.com/watch?v=RtrwkIIX5zo