In 1985, during the peak of the AIDS (acquired immune deficiency syndrome) epidemic, the International AIDS Conference was convened. Since then, the largest conference on any global health issue in the world continuously and consistently serves as a unique forum for the intersection of science, advocacy and human rights.

The 22nd International AIDS Conference (AIDS 2018) — which will be held at RAI Amsterdam Convention Centre in Amsterdam, Netherlands, from July 23 to 27, 2018, with the theme, “Breaking Barriers, Building Bridges” — is a great opportunity to strengthen policies and programs to ensure an evidence-based response to reach key populations in Eastern Europe, Central Asia, North Africa and Middle East. Amsterdam once faced a great challenge of working with populations other countries marginalized and stigmatized, including the Philippines, when HIV/AIDS became a public threat in the 1980s.

AIDS 2018 aims to promote human rights-based and evidence-informed HIV (human immunodeficiency virus) infection responses that are tailored to the needs of particularly vulnerable communities — including people living with HIV, displaced populations, men who have sex with men, people in closed settings, people who use drugs, sex workers, transgender people, women and girls and young people — and collaborate in fighting the disease beyond country borders.

Battle in the Blood, a mobile HIV/AIDS advocacy game application for HIV prevention, will have a world premiere at the 22nd International AIDS Conference. As part of the Global Village and Youth Programme Activities of the conference, the World Health Organization (WHO) organizes the global networking zone event, “Building Bridges to HIV Prevention and Testing.”

WHO, together with the Joint United Nations Programme on HIV/AIDS (UNAIDS), World Council of Churches Ecumenical Advocacy Alliance (WCC-EAA), UNITAID, PSI and SheDecides will join forces to raise awareness in order to make HIV testing accessible to all.

WHO invited the HIV GET Project team to present and launch the mobile game application, Battle in the Blood, during the conference. Battle in the Blood will have several session activities at the Global Village including a Battle in the Blood Game Challenge Conference, where participants, mainly the youth, will be recruited as contestants to play the game.

After the game challenge activity, a panel discussion on the use of mobile games as health tools for HIV/AIDS awareness, prevention, education and advocacy will follow.

Dr. Emmanuel S. Baja, DSc, a Department of Science and Technology (DOST) “Balik Scientist” and a Harvard School of Public Health alumni, is part of the faculty of the Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, and the principal investigator of the Battle in the Blood HIV Gaming, Engaging and Testing (HIV GET) Project, which is a Newton-Agham grantee funded by both the Philippines (PCHRD, DOST) and United Kingdom (MRC) governments in collaboration with the Liverpool School of Tropical Medicine.

Cooperating agencies of the project include the Department of Health, the local governments of Quezon City and Davao City, Love Yourself Inc., Engaging Tool for Communication in Health (ETCH), and Extra Mile Ltd.

The HIV Gaming, Engaging and Testing (HIVGET) Project developed a digital HIV advocacy gaming application to help address the barriers to HIV testing and counselling (HTC) in the Philippines.

Battle in the Blood (#BitB), the application, is a unique puzzle and turn-based combat mobile game. The game aims to influence social norms, knowledge and attitude surrounding HIV-AIDs and to challenge the belief that you can no longer live a long and fulfilling life after a positive diagnosis. The application, designed specifically with the Philippine context in mind, is the first game to address barriers to HTC services.

Battle in the Blood’s main target are adolescents (aged 10 to 19) and young adults (aged 20 to 24). During the design and development of the game, the focus was to make certain that the game will be acceptable, relevant and engaging, specifically among men who have sex with men and transgender women, populations known to beat high risk of HIV in the Philippines. The HIVGET team wants to ensure that MSM and transgender women feel comfortable and enjoy while playing.

The app was officially launched in Davao City on December 1, 2017, in time for the World AIDS Day Celebration. The game can be downloaded for free at Google Play and Apple Store and can be played offline. It took almost a year to transform the design document of the game to be released through agile software development using both internal and external testing sessions. For four months, the research team conducted series of interviews with target users and discussed with HIV testing and counselling service providers its objective. The team spent another three months to develop and conceptualize the 40-page game design document art.

Players will witness eight short stories on their journey across 90 levels battling HIV and its army. Players can create gender fluid avatar and can choose a variety of hairstyles and outfits from the selection list. The story is told using a dynamic 2D comic book inspired, manga-style animation, a popular form in the Philippines. The characters will be seen demonstrating courage as they overcome fears and barriers to HIV testing and treatment.

To see how each story ends, the player must complete additional 10 levels, wherein the player can choose on how to end the story for the eighth character. The screen is split into two: a puzzle board where players must connect icons to build avatar’s attack and defense power, and an animated combat scene where players get to see the combat for that round playout. The menu can be accessed at any point during the game, where they can check the leader board and where they can read different game icons and get free access online information on HIV services. Players can revisit and replay all levels and animations previously unlocked to check current standings. Players only need to answer a simple question to gain an extra life to beat the level unlike any other games in the market that require payment to continue.

Being the first gaming application of its kind, Battle in the Blood hopes to eventually help increase the uptake of HIV testing and treatment in the Philippines. It is a very powerful communication medium in addressing the stigma of HIV infection in the Philippines.