[ 7] Cornelius, J. B. and St. Lawrence, J. S. “Receptivity of African American Adolescents to an HIV-Prevention Curriculum Enhanced by Text Messaging.” Journal for Specialists in Pediatric Nursing 14, no. 2 (2009): 123-131.

[ 8] Patrick, K., Griswold, W.G., Raab, F., and Intille, S.S. “Health and the Mobile Phone,” American Journal of Preventive Medicine 35 (2008): 177–181.

[ 9] Ybarra, M. and Bull, S. S. “Current Trends in Internet- and Cell Phone-Based HIV Prevention and Intervention Programs.” Current HIV/AIDS Reports 4 (2007): 201–207.

Efforts to demonstrate this notion in the context of health care and specifically HIV transmission prevention are under way. The Texting 4 Health Conference hosted by the Stanford Persuasive Technology Lab highlighted several projects that demonstrate the efficacy of texting in changing sexual behaviors. These and similar initiatives that leverage the mobile phone to bring about sexual behavioral change were also recently illustrated in a May 2009 New York Times article, “When the Cellphone Teaches Sex Education.”

ISIS-Inc.org, one of the highlighted organizations and sponsor of the Sex::Tech Conference (an annual event that examines how technology can be used for STD/HIV prevention) focuses on the development of innovative strategies and high-tech solutions for sexual health education and STD/HIV prevention. This includes the design and deployment of sexual health promotion tools via mobile phones, the Internet, and PDAs. SexInfo is one such tool and represents an “active” sexual-health text-messaging program for youth in the San Francisco area. By texting a simple message, young people can find out what to do if a condom breaks, get help deciding if they’re ready for sex, and more.

In addition, work by Judith Cornelius and her interdisciplinary team at the University of North Carolina at Charlotte is providing an understanding of the feasibility of SMS augmented behavioral intervention in modifying sexual risk behaviors among African-American adolescents. This groundbreak-

ing work has culminated in the development and current piloting of BART+TM (Becoming a Responsible Teen + Text Messaging) BART+TM uses text messaging to supplement and reinforce the messages and skills provided by the traditionally designed (i.e. delivery via interactive group discussions and role plays) BART curriculum [ 7].

While this evidence supports the potential of mobile phone–based HIV-prevention behavioral interventions, much work remains and beckons for more active HCI involvement. Surprisingly, given the nature of the fundamental design problem—engendering behavioral change—and the technological framing—mobile phones—little exists in the literature that reflects HCI involvement in this arena, especially in the context of domestic HIV-transmission-prevention efforts. A preliminary review of the applicable technology-based behavioral intervention literature (see Table 1) makes clear a role and need for HCI involvement both conceptually—the use of interactive technologies—and more specifically—mobile phone– based implementations.

Moreover, there is a lack of understanding of significant human-factors considerations (e.g., trust, privacy, social stigma, and ethics) that may affect this more novel use of the mobile phone [ 8]. Negative, unintended consequences of use and barriers to acceptance could reduce the efficacy of these sorts of interventions, unless those factors that impact use and acceptance are discerned and addressed: the HCI imperative.

But the challenge of domestic HIV prevention is not absent from the HCI radar screen. For example, groundbreaking work by Joseph Konstan and his interdisciplinary team at the University of Minnesota is providing an understanding of risk in MSM seeking sex in online venues. However, as reflected in the calls for additional work, the HCI community can contribute much more domestically, in advancing the use of interactive technologies and, specifically, mobile phones to influence and motivate appropriate HIV-prevention behaviors.

The role for HCI involvement in this arena is elucidating and actionable especially in the context of meeting the mounting challenges facing the health care community both domestically and globally. The need is dire. The time is right. The design and research questions are rich, and, above all, the potential for impact is great.

November + December 2009

[ 10] Noell, J. and
Glasgow, R.E.,
“Interactive Technology
Applications
for Behavioral
Counseling: Issues
and Opportunities for
Health Care Settings.”
American Journal of
Preventive Medicine 17
(1999): 269–274.

[ 11] The Community Guide. “Research Gaps.” http://www.the-communityguide.org/ hiv/supportingmaterials/ RG-msm.html

ABOUT THE AUTHOR Woodrow W. Winchester, III is an assistant professor of industrial and systems engineering at Virginia Tech. A faculty affiliate of

Virginia Tech’s Center for Human-Computer Interaction (CHCI), Winchester directs the Laboratory for User-Centric Innovation in Design (LUCID) and is the co-founder and a program coordinator of Building Interfaces for Tomorrow’s Technology: The Virginia Tech Research Experience for Undergraduates (REU) in Human-Computer Interaction, sponsored by the National Science Foundation. He received his B.S., M.S., and Ph.D. in industrial and systems engineering from North Carolina A&T State University, and is an alumnus of the fifth Convivio International Interaction Design Summer School, Napier University, Edinburgh, UK.

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DOI: 10.1145/1620693.1620696
© 2009 ACM 1072-5220/09/1100 $10.00