Kombatende Sikombe

Weiming-Tang discussed digital-health innovations and HIV. His presentation highlighted gaps in scaling up digital systems, e.g., the digital divide in poor countries. Solange emphasized tracking PLHIV by PLHIV to improve drug stocks. CLM requires continuous monitoring as an accountability community innovation. It can be applied to HCV, Covid, human rights.

Social media can be used to spread HIV prevention messages using digital health. He shared how it's been used to promote MSM HIV and STI testing in China. His session overlapped Solange's, where she discussed the importance of CLM to understand community perspectives on PrEP use, prep provider locations, and crowdsourcing. Both presenters highlighted the importance of CLM data & big data in monitoring and forecasting which interventions are effective for various communities. CLM and digital-health are innovative in that they can enhance optimization of clinical interventions such as adherence and linkage to care. Weiming highlighted how gamification in digital-health can increase uptake of HIV services. In the time of Covid, digital-health was shown to be synonymous with CLM in providing avenues for peer support and counselling by helping those that want to seek emotional support. Just like digital health, Solanje shared how CLM was reliant on community systems which is often an invisible part of the health system. She further described how CLM improved HIV indicators for 6MMD in Malawi during Covid. CLM highlighted gaps in testing services among FSW. Even though funding is going up for CLM in South-Africa & Malawi, the gap remains in other countries.

Understanding who is missed in anonymized big data and reidentifying those you deidentified are implementation challenges in digital-health. Big data must be people-centered to avoid stigmatisation. To increase community engagement, we need people-centered digital health strategies. We support digital health citizen science. CLM should be viewed as a science if we are to act on Fauchi's comment that community advocacy made the HIV response possible. A few know-do gaps remain, such as the cost of running CLM, what is being scaled up, and how to make it sustainable. CLM is a new innovation that needs investment like implementation science.