By Bea Malsky, A/V Specialist
Game Changer Chicago Design Lab
Marlon is 16. He just came out to his mom. He’s not quite sure how to talk to her about his sexuality, but he’s worried he might have been exposed to HIV. He barely has time to think about health between his restaurant job and trying to succeed in high school. What should he do?
Early detection of HIV is of critical importance. Although there is no cure, modern treatments—such as FDA-approved Pre-exposure prophylaxis (PrEP), a once-a-day HIV prevention pill that is up to 99% effective when taken consistently—can control the virus so patients are less likely to transmit it to their sexual partners and can live longer, healthier lives. Despite persistent efforts to curb the spread of HIV, approximately 50,000 new infections occur each year in the United States. According to the CDC, young men who have sex with men—MSM, in public health shorthand—account for approximately 72% of all new infections among adolescents. Black men are at an especially high risk. Ci3 wanted a theory-driven mobile game that promotes testing among young MSM of color.
Here at the Game Changer Chicago Design Lab, we spent the winter illustrating scenarios like Marlon’s while building a playable prototype of our newest project: The Test. The Test is a mobile game about being a young, queer person of color confronting the need to get tested for HIV.
Through focus group work with Chicago Gay Black Man’s Caucus, GCC identified a list of common roadblocks to HIV testing. From this list, we chose four to address in The Test’s prototype: concerns around insurance coverage for testing and treatment, avoidant behavior leading to a perceived lack of urgency, weak social support networks, and discrimination within medical spaces along lines of race and sexuality.
In its prototype form, The Test follows the stories of Isaac, Marlon, and Felix. The three men are at different ages and come from different worlds, but all reach a point where they realize they need to get tested for HIV. The action of the game takes place on their smartphones, as players read the character’s conversations with their friends and family and play minigames reflecting the emotional registers of the problems they’re are facing: fear, irritation, claustrophobia, and ultimately joy and triumph.
Pairing abstracted minigames with literal descriptions of the roadblock allowed us to prioritize modeling emotion in the games and 
information in the dialogues. With this trio of character-based narrative arcs, we hoped to let players experience the emotional resonances of what can be sterile public health truisms—even when young men know they’re in high-risk categories for HIV, it is hard to translate that knowledge into action.
Isaac, Marlon, and Felix end their stories in The Test with the agency and ability to get tested for HIV. Though the game is still in early stages of development, we’re excited about its future. Treating roadblocks to HIV testing with respect for their human element isn’t a silver bullet for the systemic inequalities that lead to health disparities, but building rich stories around them does promote a more informed and empowered player and gives a vocabulary to discuss an often-stigmatized topic.
