Test, text, treat: Improving access to HIV treatment in Peru

Vía Libre, the Alliance Linking Organisation in Peru, has launched a trial which hopes to demonstrate that people supported via Facebook or text messages are more likely to access HIV treatment early and adhere to treatment than those without this additional support.

An estimated 65,000 people in Peru are living with HIV, and although the Peruvian Ministry of Heath offers free antiretroviral treatment (ART) only 35-40% of people who require treatment are accessing it. This initiative is one way that Vía Libre hopes to improve this figure. If the results prove that this additional support has a positive impact on treatment then they hope to roll it out to more clients.

The 1-1 support is a trained ‘tutor’, who will be allocated within three months of receiving a positive HIV result. Training is delivered to the tutors by a psychologist and an epidemiologist, in issues related to HIV, as well as strategies for communicating via social networks and text messaging.
Issues around client consent and remaining anonymous on Facebook, for example ensuring activities don’t reveal someone’s status, have all been thought through and mitigated.

“A mobile phone alarm to remind to take ARVs.” © MND 2014 / International HIV/AIDS Alliance / PhotoVoice

Mobile technology has been proven elsewhere to help with access to treatment and adherence . Image from a PhotoVoice workshop: “A mobile phone alarm to remind to take ARVs.”
© MND 2014 / International HIV/AIDS Alliance / PhotoVoice

The study is using a randomised control method, meaning first clients have to meet eligibility in order to make the two randomly allocated groups comparable. The eligibility requirements are that they are all men over the age of 18, have access to a mobile phone and/or Facebook, and have tested positive in the last three months.

In order to compare results, the two groups will comprise of 40 people each, one group receiving the remote peer support, and the other will receive only the current standard care information, which includes advice on the day of diagnosis along with information and next steps. All participants will be able to access the services of the Vía Libre HIV Care Centre.

The key outcome that Vía Libre will be analysing is the number of people from each group who start ART. We will share the results when available later this year.