Change My Story: a narrative game plus task-shifted therapy for young people with HIV

Change My Story: Pilot Randomized Clinical Trial of Change My Story Among Young Persons Living With HIV and Depression

This pilot will test whether the Change My Story interactive narrative game combined with task-shifted Problem Solving Therapy helps 16–24-year-olds living with HIV in Nigeria who have depression or psychological distress improve mood and medication adherence.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 80 (estimated)
• Ages: 16 Years to 24 Years
• Sex: All
• Sponsor: Massachusetts General Hospital (Academic / other)
• Locations: 1 site (Ibadan, Oyo State)
• Trial ID: NCT06389565 on ClinicalTrials.gov

What this trial studies

This is a pilot hybrid implementation-effectiveness randomized controlled trial enrolling 80 young people living with HIV (ages 16–24) with mild-to-moderate depression or psychological distress. Participants are randomized to receive the Change My Story interactive narrative game together with task-shifted Problem Solving Therapy (PST) or to receive PST alone. The intervention is delivered using non-specialized health workers to address limited mental health workforce capacity, with outcomes including depressive symptoms, functioning, and HIV treatment engagement. The trial is conducted at the University of Ibadan in Nigeria to test feasibility, acceptability, and preliminary clinical impact.

Who should consider this trial

Good fit: Ideal candidates are English-literate HIV-positive young people aged 16–24 in or near Ibadan, Nigeria, who have a PHQ-9 score between 8 and 17, are on ART for at least six months, and do not have bipolar disorder or psychosis.

Not a fit: People who are pregnant or nursing, those on ART for less than six months, those with bipolar disorder or psychosis, non-English readers, or those with more severe depression than the trial's eligibility range are unlikely to be eligible or to receive benefit from this intervention as tested here.

Why it matters

Potential benefit: If successful, this approach could give young people living with HIV an engaging, lower-cost way to reduce depression and improve adherence to HIV treatment through a scalable, task-shifted program.

How similar studies have performed: Task-shifted Problem Solving Therapy has shown effectiveness for depression in low- and middle-income countries, while the use of an interactive narrative game in this population is novel and has limited prior evidence.

Eligibility criteria

Inclusion Criteria:

* HIV-positive
* age 16-24 years
* self-reported proficiency in reading and understanding English.
* PHQ9 score of 8-17 and impairment in functioning (consistent with clinical depression)

Exclusion Criteria:

* pregnant or nursing
* in care and on ART for \<6 months
* history of- or positive assessment for- bipolar or psychotic disorder.

Where this trial is running

Ibadan, Oyo State

• University of Ibadan — Ibadan, Oyo State, Nigeria (Recruiting)

Study contacts

• Study coordinator: Aima a Ahonkhai, MD

Conditions Hiv; Depression; Psychological Distress