Skip to content

EpiC Blog

PEPFAR, USAID, MOSAIC
  • Home
  • About
  • Global Impact
  • Events
  • Resources
    • Social & Behavior Change
    • Mental Health and Psychosocial Support
    • HIV Trainings, Tools and Guides
    • Decentralized Drug Distribution
    • HIV Success Stories
    • HIV Country Resources
    • COVID-19 Trainings, Tools and Guides
    • COVID-19 Success Stories
    • COVID-19 Country Resources
  • Follow Us
Search
START TYPING AND PRESS ENTER TO SEARCH
  • Home
  • About
  • Global Impact
  • Events
  • Resources
    • Social and Behavior Change
    • Mental Health and Psychosocial Support
    • HIV Trainings, Tools and Guides
    • Decentralized Drug Distribution
    • HIV Success Stories
    • HIV Country Resources
    • COVID 19 Trainings, Tools and Guides
    • COVID-19 Success Stories
    • COVID-19 Country Resources
  • COVID-19
  • Follow Us

Do it yourself! Why "self-care" is required in the global response to HIV now and after COVID-19

July 26, 2020

COVID-19

Benjamin Eveslage, Technical Advisor, Online HIV Services, FHI 360

This blog post was originally published here on PSI’s website.


LINKself-care

The global response to HIV is now threatened on many fronts: insufficient funding, myriad challenges posed by COVID-19, and slow adoption of new HIV service technologies and delivery methods. UNAIDS now reports inequitable progress and recent setbacks in many countries. Putting HIV services and care in the hands of individuals will be part of the solution.

Community advocates, researchers, and HIV program implementers met virtually this year for the AIDS 2020: Virtual conference and discussed innovations and adaptations to help address these challenges — highlighting the conference’s theme of “resilience.” Approaches and technologies that allow people to direct and support their own HIV care—with or without a provider—was a critical topic emerging from the conference. Let’s call this “doing it yourself” or “self-care” — defined by the World Health Organization in their first normative guidance on self-care interventions for health published in 2019.

Why is self-care required to respond to HIV?

  1. PEOPLE LIKE “DOING IT” THEMSELVES!

Getting HIV under control means ensuring that people living with HIV know their HIV status, start antiretroviral treatment (ART), and reach viral suppression to prevent onward transmission (see UNAIDS 95-95-95 targets). However, clinic- and provider-based services are not a one-size-fits-all approach. Clients who want more privacy or autonomy when accessing health care are often left out. For example, key populations most affected by HIV may avoid services because of perceived and experienced stigma and discrimination in health settings.

But what can people really do themselves? HIV self-testing, for one. Testing technology has advanced over the years to make self-testing possible along with rapid policy change and implementation across various countries. For example, the STAR project in Southern Africa distributed more than 4.8 million HIV self-test kits between 2015 and 2019. The COVID-19 pandemic is accelerating rollout of HIV self-testing. HIV self-testing satisfies people’s preference for autonomy and privacy, and it is especially useful for people in settings where traditional HIV testing was limited. Young people are another important demographic for self-testing: they experience more stigma accessing sexual health services and may already be accustomed to using a whole range of at-home options from food delivery to virtual family chats. Self-care is easily marketed to target audiences directly and also championed by social media influencers who can “make HIV-related self-care famous.”

Self-care does not end at HIV testing: HIV programs may also support clients to manage their own use of pre-exposure prophylaxis (PrEP) (see on-demand PrEP), self-sampling for sexually transmitted infections, and several other self-care approaches.

  1. PEOPLE STAY HOME, MAINTAIN SAFE DISTANCE, AND REDUCE BURDEN ON HEALTH WORKERS

Supporting clients to “do it” on their own, means health workers may be “doing it” less. The resulting time and cost savings can be used to optimize the health system’s capacity to respond to HIV and COVID-19. Where to start? There are lots of options! For example, multimonth ART refills plus home delivery and virtual case management can be implemented to support uninterrupted ART and allow people living with HIV to take greater ownership of their HIV care, remain at home, and reduce unnecessary health facility visits.

COVID-19 will affect the provision of HIV services well into the future. The USAID- and PEPFAR-funded LINKAGES project in Jakarta, Indonesia is an example of how services are adapting. From March to June 2020, the project supported 47% of all PLHIV enrolled on ART in Jakarta to move from 1-month to 2-month dispensing of ART and 17.6% to receive home delivery. To support this transition, all project-funded case mangers shifted to working with PLHIV through virtual platforms.

  1. TO BETTER ENGAGE THE GROWING MOBILE GENERATION

Self-care and digital platforms are a perfect pair:  HIV services readily available for people to access on their own through their mobile phone, social media, and the internet.

Currently, about half the world’s population are active social media users, 59% are online, and 67% are using a mobile phone (see Digital 2020 report). This ever-growing trend is forcing change in many HIV programs that are losing contact with, and relevance among, this growing mobile generation. In 2018, FHI 360 supported the development of several interventions for going online to accelerate the impact of HIV programs. The Online Reservation App (ORA) was a critical innovation developed in 2017, and is now used by the ACCELERATE project in India for about 1,000 clients per month to book and access lab-based HIV testing on their own (see Yes4Me.net). ORA also is now used in 11 other countries and was re-launched in 2020 as “QuickRes” as a multicountry platform. Digital technology is a critical enabler for self-care, because people already use the internet and social media to learn about available HIV services they can use on their own.

To get the HIV response back on track, self-care models must supplement traditional clinic- and provider-led models. Even before the COVID-19 pandemic, in-person service delivery was not the preferred approach for some people, and now we live in a new world where in-person services are potentially dangerous. It’s time to recognize and embrace this change and build #better4tomorrow.

This post summarizes an AIDS 2020 satellite session “Bringing Self-Care into the HIV Response” hosted by The Self Care Trailblazer Group, Children’s Investment Fund Foundation, Population Services International, International Planned Parenthood Federation, PATH, FHI 360, Jhpiego, and Aidsfonds.

Share this:

  • Post

Post navigation

Previous

LINKAGES and EpiC at AIDS 2020 Virtual

Next

Ensuring treatment access among people living with HIV in Burkina Faso during the COVID-19 pandemic: A frontline provider’s perspective

Get Subscribed

Enter your email address to subscribe to this blog and receive notifications of new posts.

We don’t spam! Read our privacy policy for more info.

Check your inbox or spam folder to confirm your subscription.

Archives

Search by Category

Recent Publications

  • EpiC HIV Factsheet
  • EpiC COVID-19 Factsheet
  • EpiC Global Health Security Factsheet

Follow Us

  • Twitter
  • Facebook
  • Link

This blog is managed by the EpiC project and dedicated to sharing stories, events, and resources from HIV epidemic control efforts around the world.

© EpiC BLOG 2022

Assessment

A questionnaire or “screener” meant to be used with individual patients in a clinical setting to screen for, help diagnose, or monitor progress for individual mental health conditions.

Intervention

Larger packages or broader-reaching resources that describe actions or activities to be implemented. These may be appropriate for individuals, groups, and/or programs.

Anxiety

Feelings of fear, dread, and uneasiness that may occur as a reaction to stress. Anxiety can be a symptom or a feeling; it can also be a clinical diagnosis of a mental health condition.

Burnout

A state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress, typically related to one’s work, that is not managed well. Burnout is considered an occupational phenomenon.

Clinical diagnoses

Mental or neuropsychiatric disorders, or disruptive, unusual, or maladaptive behaviors that have been evaluated and diagnosed by a trained medical professional.

Depression

A mood disorder that causes a persistent feeling of sadness and loss of interest.

Disability

A physical or mental condition that limits a person’s movements, senses, or activities.

Insomnia

A sleep disorder, or disordered sleep pattern, characterized by trouble falling and/or staying asleep.

Overall well-being

The state of being comfortable, healthy, or happy; judging one’s own life positively; generally, “feeling good.”

Post-traumatic stress (PTS)

A normal adaptive response to traumatic or stressful life events that can result in a wide range of distressing symptoms. Post-traumatic stress disorder (PTSD) differs from PTS and is a clinical diagnosis.

Self-efficacy

An individual’s belief in their capacity to act in the ways necessary to reach specific goals.

Self-harm/suicidality

Deliberate injury to oneself as an emotional coping mechanism, ranging from cutting oneself to suicide. Expressions of self-harm and/or suicidality are usually considered an emergency and should be assessed and managed by a trained professional.

Social support

The perception that one is cared for, has assistance available if needed, and that one is part of a supportive social network.

Stress

Any type of change to one’s internal or external environment that causes physical, emotional, or psychological strain. “Managing stress” is an effort to return from this state of strain or disturbance to homeostasis or well-being.

Substance abuse

Use of a substance (usually drugs or alcohol) in amounts or by methods that are harmful to oneself or others. Substance use disorder (SUD) and addiction are distinct clinical diagnoses.

Trauma

Lasting biopsychosocial and/or emotional response that often results from experiencing a terrible event such as an accident, crime, military combat, or natural disaster, or a series of chronic traumatic events like persistent abuse or neglect.

Program beneficiary

Individual who receives program services; an entire group or population may be the recipient of services.

Service provider

Individual who directly provides services to another individual, group, or population (the “program beneficiary”) through a program.

Privacy Policy