Apps and Social Media Can Reach High-Risk HIV Populations

Marcia Frellick

October 28, 2016

GLASGOW, United Kingdom — Mobile applications and social media platforms can be cheap and effective ways to deliver messages about HIV testing and adherence to therapy to people at high risk for HIV, experts said here at HIV Drug Therapy 2016.

One such experience was described by Teymur Noori, from the Surveillance and Response Support Unit of the European Centre for Disease Prevention and Control (ECDC) in Stockholm, Sweden.

Last year, during HIV Testing Week in Europe, Noori was looking for ways to spread the word about an online test finder that directs users to HIV testing sites near them, which was developed by the ECDC and aidsmap.

He sent messages to the makers of three apps popular with gay men in Europe and Central Asia — Grindr, Hornet, and PlanetRomeo — to ask for their help.

"Within 10 minutes, all three said yes," he reported. At no charge, they added banners to their sites, sent messages to members, or created automatic pop-ups announcing the finder at sign-in.

About 40,000 people visited the test finder as a result of messages on those three sites, and they "viewed 74,000 testing sites in close proximity," Noori said. And it cost "no money whatsoever."

In Europe and Central Asia, the only sector in which HIV transmission rates are increasing is men who have sex with men (MSM). "That group has seen a 42% increase in 10 years," Noori said, which is "extremely worrisome from an EU perspective."

Testing in this population remains low. In 72% of countries in this region, the rate of MSM who undergo HIV testing is below 50%, according to an ECDC evidence brief.

This year, testing week has been expanded to include sexually transmitted infections and hepatitis. And during European HIV-Hepatitis Testing Week, which will run from November 18 to 25, Google has offered to add testing sites on Google Maps, at no cost.

"We think reaching out to gay men in Russia, Ukraine, and other central Asian countries is really, really important," Noori said.

Efforts to Reach MSM in Thailand

Another effective use of technology to reach MSM was described by Tarandeep Anand, behavioral research and technology specialist at the Thai Red Cross AIDS Research Centre in Bangkok.

In Thailand, one in three MSM are living with HIV, he reported, so testing and treatment need to be improved and the uptake of pre-exposure prophylaxis (PrEP) needs a boost.

"Thailand aims to end the AIDS epidemic by 2030, but only 68% with HIV are receiving treatment," Anand said.

At the same time, Thailand tops the world in social network access. In fact, he reported, MSM and transgender people in Thailand "spend an average of 7 to 8 hours a day online. Our data show that almost 80% of our clients are seeking sex online."

The first social media–based HIV outreach initiative in Asia for MSM and transgender people, called Adam's Love, was launched in 2010 and has had more than 3 million visitors, Anand reported.

People can use the site to chat online with counselors, give online consent, access their CD4 counts, schedule appointments, and get referrals for treatment.

In addition, an online test and treat program was launched by the Thai Red Cross AIDS Research Centre in 2015. Users can get HIV testing and be linked to care at conventional sites, receive pretest online counseling and get tested at a private clinic, or get a home testing kit and receive online supervised self-testing and counseling.

With LINE, the most widely used app in Thailand, users can get real-time online counseling, sign up for daily treatment reminders, talk to doctors at the center, and even report their daily medication behavior. They earn points when they use these features, which they can redeem for incentives, such as t-shirts.

The center is also trying to increase the uptake of PrEP.

"A high proportion of MSM who are aware of PrEP are willing to use it," according to a recent report on barriers to PrEP in the Asia-Pacific region (J Int AIDS Soc. 2016;19(Suppl 6):21119).

However, "key PrEP implementation barriers include poor knowledge about PrEP, limited access to PrEP, weak or non-existent HIV prevention programs for MSM and other key populations, high cost of PrEP, stigma and discrimination against key populations, and restrictive laws in some countries."

MSM and transgender women can join the Adam's Love Prep Princess Study and receive free PrEP during the 3-year study period, Anand told Medscape Medical News.

Automated reminders to take the pills are sent to participants, but users determine what the messages say and when they receive them, so they are not a violation of privacy. "A goodnight message, for instance, might mean it's time to take your pill," he explained.

Mr Noori and Mr Anand have disclosed no relevant financial relationships.

HIV Drug Therapy 2016. Presented October 25, 2016.

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