Virtual intervention for HIV prevention in India
Key information
- Organisations: Alliance India and Humsafar Trust
- Country: India
- Region: Asia and the Pacific
- Stage of Innovation: Stage 6: In the market and ready to scale
- Start date: 2021
- End date: 2023
- Type of Innovation: Services delivery innovation: new or different way of providing a service
- Funder: Global Fund
Summary of intervention
In the last decade, India has experienced massive growth in internet access, including among key and vulnerable populations, millions of whom are often unreached by HIV/AIDS programmes. Increasingly, men who have sex with men, female and male sex workers, transgender, and people who use drugs, are using internet-based communication technologies to socialise, seek clients and sexual partners, and find information and a sense of community. The changing nature of social and sexual networks among key populations offers HIV programmes innovative new tools, such as phone and dating apps, and other virtual platforms.
‘NETREACH’ is a national virtual intervention for HIV/STI prevention and sexual health implemented by Alliance India jointly with Humsafar Trust. NETREACH aims to accelerate the national HIV response to reach the ‘first 95’ targets of the National AIDS Control Programme to eliminate HIV in India by 2030.
Through NETREACH, outreach workers — Virtual Navigators — build rapport with clients who seek partners on social media and dating apps. Virtual Navigators provide HIV-related information and behaviour change communication and motivate clients to do a self-assessment of HIV risk using the NETREACH web portal. Clients are referred for services at their preferred government or private health care providers through NETREACH’s online booking process. Additionally, demand generation is created through social media advertising. A 360-degree online media campaign provides information, busts myths, and promotes healthy sexual practices.
After two years, NETREACH has reached more than five million clients. Virtual Navigators have conducted one-on-one outreach with nearly 2.5 thousand people. A total of 18,611 people from key and at-risk populations have been tested for HIV.
learnings
Close engagement with the State AIDS Control Society (SACS) had a positive impact on implementation of NETREACH at state level, especially in making HIV-related services community friendly. The project adopted tailored strategies for different target populations to achieve the desired outcome. It is necessary that Virtual Navigators continually explore the emerging social media/virtual platforms and regular community consultation is key to understanding the changing user dynamics of social media and dating apps. HIV self-testing as an additional option can boost HIV testing numbers as online populations do not want to be identified as high-risk groups. Training and collaboration with private health care providers for community-friendly services at discounted prices has proved effective.
One of the key challenges is funding for digital health interventions. Alliance India has covered NETREACH’s development and implementation through existing programmes and grants, but there are always resource constraints for innovations which are not part of specific programme deliverables. Implementing digital interventions using online technologies requires user and staff trainings, which require additional financial resources. Field and outreach staff have a limited level of internet proficiency and clients’ level of technical skills is often insufficient to access digital services (email, photos, phone capacities). Alliance India has budgeted for some trainings, but more user and staff education is needed. Going forward, the educational components of digital health interventions implementation must be planned and budgeted for.
next steps
Alliance India will keep up with innovations in the use of information technology to harness new digital communications and enhance outreach. For example, Alliance India is exploring the use of Artificial Intelligence for dynamic risk assessment, predicting high risk, and easy follow-up throughout the testing and care cascade, as well as innovative strategies to service the growing need for pre-exposure prophylaxis, post-exposure prophylaxis, hepatitis B and hepatitis C.
sustainability
Project NETREACH works closely with the SACS. Under the targeted intervention of the national HIV programme, the NGOs are trained to conduct virtual outreach. NETREACH aims to train SACS officials to conduct virtual outreach to reach key and at-risk populations who use online platforms to seek sexual partners. This will embed NETREACH in the national response for sustainability.