COVER STORY
HCI and HIV

Specific to domestic HIV-transmission prevention, efforts are occurring and evidence is surfacing suggesting the efficacy of technology-based behavioral interventions in this arena. In a 2009 meta-analysis of technology-based HIV-prevention behavioral interventions, the authors find that these technology-enabled interventions have a level of efficacy that is similar to traditionally delivered interventions (via a human) with unique benefits that could potentially increase their effectiveness over legacy means in influencing behavioral change [ 5]. Among such benefits are: a lower cost in delivery; greater intervention fidelity (intervention is delivered as designed); and enhanced flexibility in dissemination means (e.g., delivery channels).

Though quite varied in design and implementation (but potentially effective), these technology-based interventions, conceptually, can take a number of forms, including [ 6]:

Individually tailored inter- • ventions. These interventions assess characteristics of individuals and provide tailored feedback to change those determinants. An example of such intervention is Keepin’ It Safe, designed through efforts at Columbia University’s School of Social Work, a one-session, individual-level intervention administered to adolescent females via computer. The primary outcome of the intervention is the increase in HIV/AIDS knowledge, protective attitudes, and risk-reducing self-efficacy.

Interactive video inter- • ventions. These interventions provide individuals an opportu-

“”and power provide the interven- tion’s theoretical foundation. In light of these promising developments—discussed demographic trends in domestic transmission rates—and health care reform pressures to reduce delivery costs while increasing the quality of care, a perfect storm is brewing. An opportunity exists, catalyzed by more active HCI involvement, to more rigorously explore technology-based behavioral interventions, specifically mobile phone–based designs, in impacting domestic

HIV transmissions rates.

“We are on the cusp of a persuasion revolution,” says B.J. Fogg, director of the Persuasive Technology Lab at Stanford University and author of Mobile Persuasion, and “mobile phones will soon become the most important platform for changing human behavior.” Fogg asserts that the mobile phone may represent one of the most “loved” and “personal” technologies. The mobile phone is a constant companion. Offering a level of interactivity rivaling that of a personal computer, the mobile phone has the ability to layer information into one’s life—moment by moment—in a way that could motivate and influence positive behavioral change.

“The most important platform in the world for collecting and delivering targeted and tailored health information during the first half of the 21st Century will be mobile phones. Mobile phones and integrated wireless devices will revolutionize the practice of public health and touch billions of lives around the world.”

—Jay Bernhardt, director, National Center for National Health Marketing at the Centers for Disease Control and Prevention

“My takeaway message for the computer scientists here is there are some very interesting opportunities to collaborate with people solving big problems in the world, whether you’re interested in AIDS and medical problems.… There are a lot of opportunities there where you can make a difference.”

—Joseph Konstan on human-computer interaction

nity to make sexual decisions and observe the consequences of those decisions. Positive Choice: Interactive Video Doctor, developed at the Center for Health Improvement and Prevention Studies (CHIPS) at the University of California, San Francisco, is one such intervention. It is an individual-level, interactive computer-based intervention to improve screening and counseling about ongoing sex risk and substance use among HIV-positive patients.

Group-targeted interven- • tions. Group-targeted interventions contain content that has been developed with a particular group in mind. SAHARA (Sistas Accessing HIV/ AIDS Resources At-a-click), distributed by Sociometrics Corporation, is one such group-targeted, computer technology-based intervention. SAHARA is an interactive, computer-based intervention that is gender relevant and culturally sensitive for African-American women, ages 18 to 29. This intervention emphasizes ethnic and gender pride, HIV risk-reduction information, sexual negotiation skills, proper condom use, and development of partner norms supportive of consistent condom use. Social cognitive theory and the theory of gender

[ 5] Noar, S.M., Black, H.G., and Pierce, L.B. “Efficacy of Computer Technology-Based HIV Prevention Interventions: A Meta-Analysis.” AIDS 23, 1 (2009): 107–115.

[ 6] Rural Center for AIDS/STD Prevention. “Computer Technology-Based HIV Prevention Interventions.” http://www.indiana. edu/~aids/RCAPFact_ Sheet_22r3lr.pdf

November + December 2009