Background: During the duration of the project Kenya’s national HIV/AIDS strategy considered youth aged between 15 and 24 “most-at-risk” of contracting HIV, particularly young women had an HIV prevalence of 6.1% – four times higher than their male counterparts. Studies showed that, although knowledge of HIV/AIDS among youth was high, 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 project was to reach young people aged 15-19 years old with HIV behaviour-change messages through the use of a fun and innovative video game.

What did the programme involve? The game was designed for young people between 15 and 19 and 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 characters – 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 four levels of the game they find themselves in situations where their decision-making will either put them at risk of contracting HIV or help to prevent it. The game was 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.

Why this approach? Use of technology generally across urban Kenya was very high and video games appealed to young people in particular so opportunities to attract and retain their interest could be maximised.

Results observed: Pamoja Mtaani video game succeeded in drawing in and retaining young people. For example, one of the sites attracted over 4,000 young people who played the game from 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, it was found 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.

Lessons learnt: 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 stereotypes 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 by preferred by young men.

(Source: C4D Network member Nicola Harford)