Trial reportThe Lancet. Child & adolescent health2026
Efficacy of a smartphone game to increase age and condom use at first sex among adolescents in Kenya (Tumaini): a randomised controlled trial.
Trial report in The Lancet. Child & adolescent health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04437667 (Efficacy Trial for a Smartphone Game to Prevent HIV Among Young Africans), which is not on this map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Efficacy Trial for a Smartphone Game to Prevent HIV Among Young Africans
Who cites it
2 citing papers in PubMed.
- Longitudinal Effects of a Smartphone Game (Tumaini) for HIV Prevention Among Kenyan Adolescents: 45-Month Trajectories of Condom Use-Related Proximal Outcomes From a Randomized Controlled Trial.Journal of medical Internet research · 2026Trial
- Efficacy of an Interactive Life Simulation Gaming App on Improving HIV Testing Uptake Among Adolescents and Young Adults at Risk for HIV: Results of a Randomized Controlled Trial.JMIR serious games · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
backgroundLow-cost and scalable behavioural interventions to prevent HIV among young people in Africa are needed. As access to smartphones grows, digital interventions will become increasingly viable. We assessed the efficacy of an interactive narrative-based smartphone game (Tumaini) designed to increase age and condom use at first sex.
methodsIn this two-arm, non-blinded, individually randomised trial, participants aged 12-14 years were recruited at community level in Kisumu, Kenya. Sex-stratified block randomisation (1:1; block size of 10) was undertaken by study staff with no contact with participants. For three 5-7-week gameplay periods during school holidays in the first 3 years, participants in the intervention group received Tumaini and participants in the control group received Brainilis, a maths game, on study-provided low-cost smartphones. Participants were followed-up for 45 months, completing a baseline survey and 12 follow-up surveys. Assignment was known to trial staff but masked to data analysts. The primary outcome was a binary measure of high-risk sexual debut (no condom use) versus low-risk (condom use) or no sexual debut, assessed at endline in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT04437667, where it is suspended pending extension.
findingsBetween Oct 1 and Dec 3, 2020, 996 adolescents (mean age 14·0 years [SD 0·6]; 499 in the intervention group and 497 in the control group) were enrolled. At endline, 974 (485 in the intervention group and 489 in the control group, and 484 female and 490 male) completed the study and were included in the intention-to-treat analysis. Excluding those reporting sexual debut before baseline, 10% (41 of 409) of participants in the control group reported a high-risk sexual debut compared with 6% (23 of 407) of participants in the intervention group (risk ratio [RR] 0·56 [95% CI 0·34-0·92]). For female participants, 10% (21 of 207) in the control group and 3% (seven of 206) in the intervention group reported a high-risk sexual debut (RR 0·34 [95% CI 0·15-0·77]). For male participants, this outcome was not significantly different, with 10% (20 of 202) of participants in the control group versus 8% (16 of 201) of participants in the intervention group reporting a high-risk sexual debut (RR 0·80 [95% CI 0·43-1·51]). There was no difference in experience of or age at sexual debut. No serious adverse events resulted from trial participation.
interpretationThe results of the study provide evidence to support the potential of digital behavioural HIV prevention, serious games for sexual health, and pre-sexual risk intervention among adolescents in sub-Saharan Africa.
fundingUS National Institute of Mental Health and Emory Center for AIDS Research.
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