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HIVNCT04437667

HIV-Prevention Smartphone Game Trial

A study testing Tumaini Mobile Phone Game in people with HIV, run by Emory University at 1 site in Kenya.

Suspended

Paused. Enrolment is on hold for now and may resume.

Official record
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Trial summary

This project, funded by the National Institute of Mental Health, will test the efficacy of an electronic game to prevent HIV among African adolescents (aged 12-17), delivered via inexpensive Android smartphones. Read more about this study

Who is it for?
Ages 12 to 14 yearsHealthy volunteers can take part
Conditions the study is for
HIV
What is being tested?
Tumaini Mobile Phone Game
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,000 participants
Where
1 siteKenya
Study dates
12 Oct 2020to Aug 2028
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 12 to 14 years
  • All sexes
  • Healthy volunteers accepted
  • Child

Who may be able to join

  • Aged 12-14 at time of enrollment
  • Resident in Kisumu Town, Kenya
  • Having basic English literacy (Grade 3-4 on the Flesch-Kincaid Reading Scale, assessed via a short listening and reading comprehension test at enrollment)
  • Only one child per family
  • Not previously enrolled in formative research or pilot testing of intervention or survey instruments

Who cannot join

  • Aged <12 or >14 at time of enrollment
  • Not a resident of Kisumu Town, Kenya
  • Not having basic English literacy
  • Sibling to a child already enrolled in the study
  • Previously involved in formative research or pilot testing of intervention or survey instruments

Trial locations and contacts

1 site in 1 country.

Kenya1 site
  • Kenya Medical Research Institute

    Kisumu

Other trials in Kenya

About this study

Official title: Efficacy Trial for a Smartphone Game to Prevent HIV Among Young Africans

This project, funded by the National Institute of Mental Health, will test the efficacy of an electronic game to prevent HIV among African adolescents (aged 12-17), delivered via inexpensive Android smartphones. This study involves a sample of 912 young people and 500 of their parents in Kenya's former Nyanza province, where 11.4% of young women and 3% of men ages 15-24 are HIV-infected. This study will be carried out by Emory University and the Kenya Medical Research Institute (KEMRI).

Read the detailed description

The 912 study participants (youth ages 12-14) will be randomized to the intervention or control arm upon completion of the baseline survey. The assignments will be generated with the use of a pseudo-random-number generator with permuted blocks, used to ensure a sex-balanced and age-balanced assignment to each arm. All participants will be given a low-cost (<$40) Android phone on which the study game will be loaded. Intervention arm phones will have app for Tumaini programmed on them, while control arm phones will have a commercially available game to be determined prior to the start of the randomized clinical trial. Preference will be given to a game or other app with educational content, for example, a general knowledge quiz or strategy game. Each app will be standalone and not require data access or connection to the Internet to function. All participants will be invited to play their assigned game for at least 10 hours during the November-December school holiday. While we anticipate that access to smartphones will be widespread at time of roll-out of an efficacious game, this is not yet the case: for the purposes of this study, phones need to be provided in order to ensure consistency of technology and avoid SES bias. All other phone functions aside from the alarm, will be disabled for safety reasons. The game will automatically record the time spent playing and the choices made in the context of gameplay. When returning the phones, all participants will be asked to fill out a form identifying others with whom the game or app was shared and creators of each profile on their study phones.

In line with the preferences expressed by parents during the feasibility test, the phones will be provided to participants during the long November-December school holidays and collected at the end of the holiday. Providing there is no evidence of contamination, participants will (a) keep the phone throughout the long November-December school holiday; and (b) receive the phone, loaded with the game, again during the November-December holidays of the following years.

Conditions
HIV
Being tested
Tumaini Mobile Phone Game, Control Mobile Phone Game
Keywords
HIV, Adolescents, Prevention, Sexually transmitted infections (STIs)
Medical subject headings
Sexually Transmitted Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Tumaini Mobile Phone GameBehavioural

    Tumaini is a scenario-based role-playing game application. Participants will be instructed to engage in a minimum of 10 hours of gameplay over the holiday period each year. The game will automatically collect for analysis data related to participants' in-game behavior, e.g. time spent playing, scores on knowledge-based mini-games, choices made in the narrative game, components to which the player was exposed. The game is designed to: educate players about sexual health and HIV/AIDS; build risk-reduction skills and related self-efficacy for prevention of HIV/STIs and unintended pregnancy; challenge HIV stigma; and promote parent-child dialogue.

  • Control Mobile Phone GameBehavioural

    Independent gameplay of control game. Total respondent burden: participants will be invited to engage in at least 10 hours of gameplay during each long school holiday (November-December).

Study groups in NCT04437667
Study groupRoleWhat they receive
Intervention ArmExperimentalAdolescents participants enrolled in the intervention arm will receive the intervention, Tumaini, loaded on a low-cost Android smartphone, during the long November-December school holidays for the first three years of the study.
Receives: Behavioral: Tumaini Mobile Phone Game
Control ArmActive comparatorAdolescent participants enrolled in the control arm will receive a commercially available age- and language-appropriate educational game or knowledge quiz loaded on a study-provided low-cost Android smartphone.
Receives: Behavioral: Control Mobile Phone Game

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Age at first sex

    Age at first sex encounter.

    Measured: Up to month 46

  2. Percentage of participants reporting condom use at first sex

    Percentage of participants reporting condom use at first sex

    Measured: Up to month 46

  3. Binary Risk outcome of "risk" vs "low risk"

    Binary outcome of "risk" group (experienced sexual debut during the study period without condom use at first sex) vs "low risk" group (not yet experienced sexual debut by the end of the study, or used a condom at sexual debut during the study period).

    Measured: Up to month 46

  4. Change in percentage of participants reporting recent sexual activity

    For participants reporting previous sexual intercourse, self-report of sexual intercourse since previous behavioral survey.

    Measured: Months 1, 3, 6, 9, 12, 17, 22, 25, 30, 34, 37, 42, 46

  5. Change in percentage of participants reporting recent condom use

    For participants reporting recent sexual activity, self-report of consistent condom use since previous behavioral survey.

    Measured: Months 1, 3, 6, 9, 12, 17, 22, 25, 30, 34, 37, 42, 46

  6. Change in number of sexual partners

    For participants reporting any past sexual activity, number of different sexual partners

    Measured: Months 1, 3, 6, 9, 12, 17, 22, 25, 30, 34, 37, 42, 46

  7. Change in percentage of participants with recent alcohol and drug use

    Percentage of participants that report recent alcohol and drug use.

    Measured: Months 1, 3, 6, 9, 12, 17, 22, 25, 30, 34, 37, 42, 46

  8. Change in knowledge

    Knowledge measures will be assessed via Yes/No survey questions and will address HIV, sexually transmitted infections (STIs), pregnancy, and condoms. Answers to knowledge questions will be coded as 0 or 1, with higher scores indicating more accurate knowledge. A positive value for the change from baseline score indicate an increase in knowledge from the baseline assessment.

    Measured: Months 1, 3, 6, 9, 12, 17, 22, 25, 30, 34, 37, 42, 46

  9. Change in self-efficacy

    Self-efficacy will be assessed via a Likert scale, and focus on self-efficacy to use a condom correctly; to communicate with a partner about protected sex; to reject peer, partner, and adult pressure to engage in risk behaviors; and, for female participants, to manage menstruation. Self-efficacy will be scored on a 0-1 scale with higher scores indicating stronger self-efficacy. A positive value for the change from baseline score will indicate an increase in self-efficacy since the baseline assessment.

    Measured: Months 1, 3, 6, 9, 12, 17, 22, 25, 30, 34, 37, 42, 46

  10. Change in risk assessment

    Risk assessment will be assessed via a Likert scale, and address perceived risk of certain risk situations/behaviors. Risk items will be scored on a 0-1 scale, with higher scores indicating higher risk assessment. A positive value for the change from baseline score will indicate an increase in assessing risky situations as risky.

    Measured: Months 1, 3, 6, 9, 12, 17, 22, 25, 30, 34, 37, 42, 46

  11. Change in attitudes

    Attitudes will be assessed via Likert survey questions relating to puberty, HIV stigma, condoms, sex, and gender. Attitudes items will be scored on a 0-1 scale, with higher scores indicating more desirable attitudes. A positive value for the change from baseline score will indicate an increase in desirable attitudes.

    Measured: Months 1, 3, 6, 9, 12, 17, 22, 25, 30, 34, 37, 42, 46

  12. Change in behavioral intentions

    Behavioral intention will be assessed via Likert survey questions. The measure will address intention to avoid risk situations and to engage in health protective behaviors. Behavioral intention items will be scored on a 0-1 scale with higher scores indicating more intention to partake in health protective behaviors and a positive value for the change from baseline score indicating an increase in intention to engage in health protective behaviors.

    Measured: Months 1, 3, 6, 9, 12, 17, 22, 25, 30, 34, 37, 42, 46

Secondary outcomes (3)
  1. Total length of gameplay

    Total time playing from game log files

    Measured: Months 3,18, 28

  2. Number of participants with new HSV-2 diagnosis

    Incidence rates over the course of study of HSV-2 among uninfected participants will be compared by exposure to intervention using Poisson and/or Cox regression methods.

    Measured: Months 1 and 46

  3. Number of participants with new HIV diagnosis

    Incidence rates over the course of study of HIV among uninfected participants will be compared by exposure to intervention using Poisson and/or Cox regression methods.

    Measured: Months 1 and 46

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Jun 2020
  2. Study start12 Oct 2020
  3. Primary completionAug 2028 (estimated)
  4. Study completionAug 2028 (estimated)

Why it stopped: Research activities are currently paused waiting for an answer about a renewal proposal to extend the study.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
1,000 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04437667
Sponsor's protocol ID
IRB00108404
Other IDs
1R01MH118982-01
Status last verified
Sep 2025
First submitted
16 Jun 2020
Last updated
6 Oct 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Winskell K, Sabben G, Mbeda C, Ondeng'e K, Arego J, Qin H, Goldenberg S, Ndivo R, Komro K, Bednarczyk RA, Lyles RH, Mudhune V. Efficacy of a smartphone game to increase age and condom use at first sex among adolescents in Kenya (Tumaini): a randomised controlled trial. Lancet Child Adolesc Health. 2026 Apr;10(4):273-283. doi: 10.1016/S2352-4642(25)00353-0.

    PubMed 41819981
  • Winskell K, Sabben G, Qin H, Mbeda C, Goldenberg S, Ondeng'e K, Ndivo R, Arego J, He X, Bednarczyk RA, Komro K, Lyles RH, Mudhune V. Longitudinal Effects of a Smartphone Game (Tumaini) for HIV Prevention Among Kenyan Adolescents: 45-Month Trajectories of Condom Use-Related Proximal Outcomes From a Randomized Controlled Trial. J Med Internet Res. 2026 Mar 10;28:e83982. doi: 10.2196/83982.

    PubMed 41806862
  • Mudhune V, Winskell K, Bednarczyk RA, Ondenge K, Mbeda C, Kerubo E, Ndivo R, Arego J, Morales M, Halliburton B, Sabben G. Sexual behaviour among Kenyan adolescents enrolled in an efficacy trial of a smartphone game to prevent HIV: a cross-sectional analysis of baseline data. SAHARA J. 2024 Dec;21(1):2320188. doi: 10.1080/17290376.2024.2320188. Epub 2024 Feb 22.

    PubMed 38388022
  • Mudhune V, Sabben G, Ondenge K, Mbeda C, Morales M, Lyles RH, Arego J, Ndivo R, Bednarczyk RA, Komro K, Winskell K. The Efficacy of a Smartphone Game to Prevent HIV Among Young Africans: Protocol for a Randomized Controlled Trial in the Context of COVID-19. JMIR Res Protoc. 2022 Mar 3;11(3):e35117. doi: 10.2196/35117.

    PubMed 35030090

Questions about this trial

What is this clinical trial studying?

A study testing Tumaini Mobile Phone Game in people with HIV, run by Emory University at 1 site in Kenya.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: paused, as of the sponsor's last update on 6 Oct 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Kenya. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Age at first sex (time frame: Up to month 46). The study lists 12 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04437667, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Oct 2025.

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