Going online to ensure uninterrupted HIV services during COVID-19 in Nepal

BACKGROUND: In Nepal, the COVID-19 pandemic placed substantial pressure on HIV programs to adapt to new physical distancing policies and restrictions in movement that limited people from accessing HIV services in person. Building upon five years of online HIV service delivery, the PEPFAR- and USAID-supported LINKAGES and EpiC programs in Nepal amplified the government and community partners' online efforts to ensure safe and sustained HIV service access during the COVID-19 pandemic.
DESCRIPTION: From March to October 2020, EpiC Nepal supported a dramatic shift toward virtual client support and online HIV service access. New devices and mobile data packages were procured for outreach workers and community-based supporters to maintain contact with key populations and people living with HIV (PLHIV). Virtual and online support was also facilitated by the development and dissemination of new key messages on HIV and COVID-19 prevention, care, and treatment. EpiC upgraded the project's online reservation application,available at www.merosathi.net, with additional services available for booking and a new program-facing case management system. Several popular social media influencers were mobilized as 'virtual peer champions' to promote benefits of HIV treatment and care, including through the newly available virtual or online channels.
LESSONS LEARNED: From March to October 2020, 40,230 individuals received information on HIV and COVID-19 prevention virtually'a rate five times higher than in the July 2019 to February 2020 period.A total of 11,744 PLHIV were reached virtually for treatment adherence support, monitoring, and education,which was not done before the COVID-19 pandemic; 906 individuals tested for HIV and 141 were diagnosed with HIV from online approaches. Among all the individuals (906) who were linked through online engagement to off-line HIV testing services, 16 percent received positive results'a rate three times higher than in the July 2019 to February 2020 period, when 612 individuals were tested and 31 individuals were diagnosed with HIV.
CONCLUSIONS: Our findings suggest that online approaches provided continued service access for key populations and PLHIV. Institutionalizing virtual solutions in Nepal helped safeguard gains made in the HIV response from the ongoing COVID-19-related service disruptions and other future threats.Our experience helped facilitate formal adoption of online interventions in Nepal.