HIV patients demonstrated greater adherence to their antiretroviral therapy (ART) following the use of a low-cost educational VR application, according to a new study published in the Interactive Journal of Medical Research.
Delivered in English and Spanish on a Dell Windows Mixed Reality headset, the seven-minute experience consisted of an interactive look at the cells and pathogens of a virtual HIV patient.
Participants were shown a dramatized scene of bacteria attacking the body in which white blood cells had been destroyed by HIV. Later, they could press a button to administer ART, preserving the white blood cells and allowing them to fend off the bacteria’s attacks. The experience’s narrator would conclude the session by stressing the need for continued ART adherence to prevent the negative outcome.
Self-reported adherence significantly increased among a subset of 67 HIV patients who completed a questionnaire before and after receiving the VR experience (P < .001).
Across the full 107-person study, HIV viral load decreased after the intervention (P = .02), whereas no significant change was detected among a second viral load drawing conducted before the experience was assigned. While there was no study-wide difference in CD4+ T helper cell counts from start to finish, the researchers did see an increase among those whose pre-VR cell counts were below normal (P = .03).
In a questionnaire administered directly after the VR experience, no participants said that the intervention was uncomfortable, 94% reported they were likely to better adhere to ART as a result of the intervention and only two said that they learned nothing new from the experience.
HOW IT WAS DONE
The researchers recruited their study participants from a UCLA HIV clinic during 2018. Each patient was required to have an HIV diagnosis and be receiving highly active ART. Just before receiving the VR intervention, these patients self-reported their adherence in a face-to-face interview, completed a questionnaire about the VR experience immediately after its conclusion and then re-reported adherence over the phone or in person two weeks later.
The researchers obtained viral load and CD4+ T helper cell counts from digital charts, which included standard clinic protocol blood draws. They included the count of the most recent draw conducted before the intervention (pre-draw), the draw recorded before that (second pre-draw) and another recorded at least 14 days after the VR experience (post-draw).
WHAT’S THE HISTORY
VR has often been used to educate the public and patients about health, among other implementations. For example, a partnership between Cedars Sinai and a community church group for health education initiative aimed at reducing hypertension in a vulnerable population. Similarly, Boston Children’s Hospital announced a partnership last year with Kick Health to deliver the HealthVoyager education platform for pediatric patients, while an NIH-backed prototype is allowing participants to view how their genes may be impacted by environmental factors.
"If the results are confirmed, VR’s effectiveness and relative low cost offers a great opportunity for clinics to implement a simple solution that may improve both the morbidity and mortality of their patients,” the researchers wrote. “Future studies should attempt to generalize the results to other settings, populations, and illnesses — especially those in which patients feel healthy and may not feel the need for taking their medications as scheduled. Compared with other traditional media platforms such as videos, VR is more immersive and thus has a greater positive emotional impact, which can improve engagement and learning.”