Applying Gamification Principles to a Mhealth App to Support Adherence to Hiv Medication in a Resource-Limited Setting.

Medication adherence is a predictor of mortality and morbidity for people living with HIV, with many youth living with HIV (YLWH) in low- and middle-income countries (LMICs) having low adherence rates. This paper details use of gamification principles to develop a medication adherence app (PEERNaija) to support YLWH in Nigeria. The employed gamification features were informed by theory-driven approaches, other similar applications, broad-based focus group discussions, wireframe-based feedback, and revisions after 6-months of end-user testing, feedback and application use. Key gamification features employed included personalization, points, progress tracking, leaderboards, achievements, and normative messaging, among others. By employing a user-centered approach in a culturally-relevant context, we were able to develop an application that appealed to YLWH, encouraging them to take and log their medications while incentivizing them to reach the adherence levels required to adequately control their HIV disease. Evaluation of various elements of the intervention is underway.