The Safe Box Scheme

A picture showing the contents of the Safe Box, including condoms, lube and an HIV self test kit

Key information

Organisation: Alliance for Public Health
Country: Ukraine
Region: Eastern Europe and Central Asia
Stage of innovation: Stage 6: In the market and ready to scale
Start date: Apr 2020
End date: Sep 2021
Type of innovation: Service innovation: new or improved service
Funded by: USAID

Summary of intervention

In Ukraine, COVID-19 restrictions have meant many NGOs serving men who have sex with men have been unable to provide HIV testing.

APH has designed a solution to address this. Men who have sex with men use the website https://oraltest.org.ua to order ‘safe boxes’ for them and/or their sexual partners. The boxes arrive by post and contain an oral HIV test, condoms, lubricant, information on HIV and PrEP, a local social worker’s business card, and motivational merchandise. People test for HIV by following interactive instructions and videos on the website. The website also provides live online advice from social workers.

The scheme was originally for Dnipro, Donetsk, Zaporizhia, Kherson, Odessa and Mykolayiv but spread to the whole of Ukraine during lockdown. To date, 792 safe boxes have been ordered by 610 people (a mix of urban and rural): 92% were men, 7% were women and 1% were trans. 54 people used online instructions for HIV testing, 18 indicated their result (no positive results were recorded), and 25 people did not indicate their result. Feedback indicates the online service has made men who have sex with men feel supported and cared for during this difficult time.

Learnings

Men who have sex with men helped design the safe boxes and website and pilot the innovation. This was essential for the project’s success. There are plans to survey website users for feedback.
Although the target group was men who have sex with men, women also used the service for themselves, their bisexual partners and gay friends.
The innovation provides a high level of confidentiality, which is particularly important for men who have sex with men from small towns and villages.

next steps

Currently, funding for this activity is only provided for six regions. But given the popularity of the website throughout Ukraine, APH is interested in pursuing additional funding.
There are plans to add an ‘assess your risk’ section to the website so users can learn about their risk of HIV, hepatitis and syphilis. There are also plans to design support for users who receive an invalid or positive test result.

Sustainability

The website does not require significant changes, has easy interface and administrative functions so it can easily be transferred to the government for further use.