Going Online: pilot of a complementary virtual approach to engage key populations and other hard-to-reach people with HIV services


BACKGROUND: The PEPFAR- and USAID-funded Meeting Targets and Maintaining Epidemic Control (EpiC) project, led by FHI 360 in Liberia, is piloting Going Online (GO), a complementary approach to maximize reach and provide a comprehensive package of HIV services to key populations (KPs) and other hard-to-reach people. GO is primarily intended to increase reach to unreached individuals, engage them using online platforms, and connect them to HIV services.
DESCRIPTION: EpiC Liberia used an app called QuickRes developed by FHI 360 to manage clinic appointments and complete the cascade of HIV services. EpiC identified and trained two community peer outreach workers (OWs), as well as 'elite' outreach workers (elite OWs). The latter are professional health workers recruited for their skill and rapport with clients. Peer educators assisted clients with taking an online risk assessment that helped the client decide which services they needed. The app then walked clients through the booking process, helping them identify the nearest of seven PEPFAR-supported facilities where they could receive HIV services.
LESSONS LEARNED: We launched QuickRes on July 19, 2021, and have reporting through December 8, 2021. EpiC successfully reached and booked 311 clients (236 KP clients booked by peer OWs, and 75 general population clients booked by elite OWs). All 311 clients (100%) arrived at the facilities, and 30 clients who rebooked for antiretroviral therapy (ART) refilled successfully, for a total of 341. Overall, 62 clients (18%) tested positive, and all were initiated on ART; this is the highest case-finding rate within the subsets of case-finding strategies for EpiC Liberia. The HIV case finding from KP clients booked through community OWs was 21.6% (51/236). The HIV case finding from elite OWs was 14.7% (11/75). Ordinary outreach testing in the project had a case-finding rate of 11% during the reporting period.
CONCLUSIONS: Using peer OWs improved reach among key population individuals, who are more likely to be positive. There are ongoing efforts to document and scale up best practices from the pilot as we strive to replicate results in other areas of Liberia.

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