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Adam´s Love 7-Milestones positive journey map: A novel online-to-offline (O2O) HIV care strategy for early linkage to treatment and optimal retention in care among Thai HIV-positive MSM Title Adam´s Love 7-Milestones positive journey map: A novel online-to-offline (O2O) HIV care strategy for early linkage to treatment and optimal retention in care among Thai HIV-positive MSM DOI: 10.13140/RG.2.2.23575.93606 10TH IAS CONFERENCE ON HIV SCIENCE (IAS 2019). MEXICO CITY, MEXICO | 21-24 JULY 2019., DOI:10.13140/RG.2.2.23575.93606 URL http://programme.ias2019.org/Abstract/Abstract/512 Download the e-Poster https://programme.ias2019.org//PAGMaterial/eposters/512.pdf Presenter Tarandeep Anand Authors T. Anand, P. Saengow, K. Fungfoo, S. Guistino, C. Nitpolprasert Conference 10th IAS Conference on HIV Science | 21-24 July 2019 | Mexico City, Mexico Background: Despite rapid proliferation of digital 4.0 technologies, Thailand lacks an integrated online linkage support system, a key factor behind delayed linkage to antiretroviral treatment (ART) and lower rates of viral suppression among Thai HIV-positive men who have sex with men (MSM). Novel models that overcome barriers in traditional face-to-face outreach and transform HIV care delivery are critical to optimizing HIV cascades. Methods: Adam''s Love (www.adamslove.org/wecare), leading technology-based MSM health initiative leveraged a 7-Milestones positive journey map built upon its novel online-to-offline (O2O) model. Seven key milestones included 1) enrolled newly diagnosed MSM registering at Adam''s Love instant-messaging platforms (LINE/Messenger) and receiving eCounselling, 2) completing healthcare insurance procedures/formalities, 3) successful referral and early linkage to care, 4) ART initiation, 5) optimal ART adherence achieved through individualized eCounselling support and daily-personalized ART reminders, 6) retention in care, and 7) MSM successfully achieving an undetectable viral load (UVL). We measured the impact of the innovation on the milestones accomplished. Results: Between March 2017-December 2018, Adam''s Love referred 1,350 MSM and linked 997 (73.9%) to HIV testing sites across Thailand. Of 219 Thai MSM diagnosed HIV-positive, 96 MSM located in Bangkok (68.1%) and other provinces (31.9%) enrolled in the study. Median (IQR) age was 26 years (24-30), 89.6% self-identified as gay and 10.4% bisexual. Majority (61.5%) had attained a bachelor''s degree. Almost half (46.9%) had sought sex online. Participants located outside Bangkok were comparatively younger (< 25 years) (49%vs.30%). All 96 MSM were successfully linked to care, 94 initiated ART and 91 accepted daily ART reminders. Majority 48/94 MSM (51%) accessed treatment through social security scheme, 34 (36%) via universal health coverage, 5% were self-paid and others 8%. At month 6, self-reported mean score of daily ART adherence was 97.23 (SD 5.72). By December 2018, 45 MSM successfully achieved an UVL and median (IQR) time between enrollment and UVL was 7 (6-9) months. Fifteen MSM shared success stories through www.myundetectablestory.org, Adam''s Love user-driven platform to empower future participants. Conclusions: Our innovation simplified post-diagnosis procedures for HIV-positive MSM and outlines practical pathways for providers and communities in resource-limited settings to overcome barriers in conventional service delivery.
ACKNOWLEDGEMENTS
Research supported by MAC AIDS Fund, ViiV Healthcare, the Positive Action for Adolescents program and amfAR through a grant from the National Institute of Health’s National Institute of Allergy and Infectious Diseases, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Cancer Institute, National Institute of Mental Health, and National Institute on Drug Abuse as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA; U01AI069907). We thank all participants and study staff for their significant contributions. |
