Providing Informational Support to HIV+ Women in a Virtual Environment: A Case Study Comparing the Effects of Virtual Reality and Paper Media for Content Delivery

South Africa has one of the highest HIV+ prevalence rates in the world [1]. Furthermore, social support is beneficial to HIV+ people. Informational support is a type of social support which is used to increase one’s knowledge base [2]. Hayes et al. state that informational support is especially beneficial for those in the early stages of HIV infection [3]. Computer technologies have been used successfully in providing informational support to their users. However, virtual reality (VR) is a relatively unexplored technology in South Africa, and we feel it is a highly appropriate medium for a context where users have little or no prior computing experience. Traditionally, computer interfaces require users to have a learned skillset, but a VR interface does not necessarily require this as it maps more directly to users’ natural interaction techniques with the real world. A key benefit of a virtual environment (VE) is the interactivity and user involvement that it offers through a high degree of navigation and interaction with objects [4]. VR may, initially, seem to be an expensive technology to use in a developing country but it is possible to make use of desktop VR on a consumer-grade PC relatively affordably. This dissertation presents a comparison of the effects of two media, VR and paper (i.e. pamphlets) in communicating supportive information to an HIV+ sample group. We created a VE to provide social and informational support for HIV+ people in the South African context. The design of the VE placed emphasis on creating a typically South African space which users could recognize and find familiar. Our research focused on two rooms containing virtual agents and points of possible interaction: the lounge and the kitchen. In the lounge, a HIV/Aids support group was simulated while the kitchen contained two areas which presented nutritional informational support: Diet and Cleanliness & Hygiene. We conducted a pre- post-test study with 22 HIV+ women at two clinics in Cape Town. Participants were randomly assigned into one of three groups. One group experienced the informational VE (VE), one group received information pamphlets (Text), the control group who received no information until the end of the study (Ctrl). Participants attended three experiment meetings over a five week period. Participants completed two 3-day food diaries and completed questionnaires that provided measurement for two sets of variables: Food Safety Behaviours (a measure of knowledge of correct food and water safety practices to prevent food-borne illnesses) and Dietary Quality (measure of the diet quality – in terms of quantity, variety, water intake and vitamin supplements, as well as specific food items for the prevention of stomach ailments, a common complaint of HIV infection). While we found no differences between the Text and Ctrl groups, the VE group showed a significant improvement in consuming two (of three) specific food items recommended for the prevention of stomach complaints. This is a particularly striking result given that more than half the participants stated that they routinely did not have enough money to buy food let alone specific healthy foods. The area that contained the information related to stomach complaints was the last imagery experienced by all VE participants. That it was the only area that showed improvement highlights how careful VE authors should be in choosing the actual content for the environment, as well as how that content is delivered. Despite very minimal computing experience and only short training sessions, all participants mentioned that they found the VE easy to use and enjoyed their experience of it. Our results show that VR can indeed be used to deliver informational content to HIV+ women in South Africa