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In prevention-oriented HIV social research, one of the major methodological challenges is to address the interactive nature of sexual encounters and protection behavior. As realistic alternatives are hardly available, research has relied on retrospective self-reports to capture protection behaviors in various contexts and diverse groups. In response to their known flaws, recent desiderates called for digital technologies to increase participants’ engagement and emotional and social involvement. When investigating how men having sex with men (MSM) negotiate their HIV protection with non-steady partners, we chose to use a Virtual Reality Serious Game (VR-SG) immersing participants in situations similar to those they might encounter in real life. Therefore, we explored how to design a VR-SG, its use in qualitative in-person interviews and whether it enriches interview data.
Methods
We conducted problem-centered interviews with five MSM from diverse backgrounds, exploring how they negotiate HIV and STI protection, and conducted guided expert interviews with five sexual health advisors on the same issue. Using qualitative content analysis, we identified exemplary courses of negotiations.
Drawing on these insights, we designed a VR-SG immersing participants initially in a dating platform chat and subsequently – depending on its outcome – on a date in the virtual partner’s (VP) apartment. We designed ten Petri nets for all possible interactions with the VP leading to nine different plots. We scripted 34 authentic dialogues with a professional actor. We filmed using a 360-degree camera mimicking the participants’ view in a conversation with the VP (played by an actor) and loaded it up to a custom-built game engine. As the story unfolded, the VP asked a question, and the participant had to choose the most suitable answer from a list of faded-in options. Based on the response, the game revealed the next scene until the participant faced a pre-determined ending.
We conducted a usability experiment with five MSM and pre-released the VR-SG on the Oculus Rift for the research project. We also implemented a default workflow that mirrors the participants’ view in VR on the interviewer’s smartphone using the Oculus App to monitor their moves.
Findings
Our development process resulted in a VR-SG ready to use in qualitative in-person interviews. We used it in 19 interviews.
Regarding interview dynamics and data generation, we observed that the VR-SG prompted the participants to share their lived experiences more extensively and in-depth. They recalled episodes they had not mentioned before the game, brought up new topics and complemented the narratives from before. The interview atmosphere became more informal and subsequent narratives were less controlled.
In three interviews, the VR-SG was interrupted due to problems with the internet connection. In five instances, it was not possible to stream it on the smartphone for monitoring.
Conclusions
Our development process was conducive to creating an operational VR-SG for use in qualitative research. The integration of the VR-SG in personal interviews proved feasible and useful although the technology is susceptible to technical vulnerabilities. Using a VR-SG in qualitative in-person interviews is productive and enriches interview data.