Online-to-Offline model highly effective in reaching at-risk groups with PrEP services in Thailand

29 March 2017

Digital intervention shows success linking hidden, at-risk men who have sex with men (MSM) and transgender women with HIV testing and PrEP services – and has the potential to be replicated elsewhere with high internet penetration.  

Asian man on his phone

An innovative online-to-offline (O2O) model has been shown to be highly effective in linking at-risk men who have sex with men (MSM) and transgender women with pre-exposure prophylaxis (PrEP) services in Bangkok, Thailand.

The Adam’s Love O2O model targeted online and at-risk key affected populations in Bangkok, Thailand with social media PrEP promotion campaigns, including educational content and photos and videos featuring Thai celebrities.

Viewers could then seek eCounselling support, answering a standard list of questions based on their behaviours before booking an appointment at a clinic of their choosing using a free e-booking service.

The project piloted between January and April 2016. In this time, 425 MSM and transgender women received eCounselling and were booked into local clinics. 76.5% actually visited the clinic for HIV testing and counselling, and 2.8% were diagnosed as HIV positive. Of the HIV-negative individuals, just over half (53.2%) started PrEP.

MSM and transgender women remain a key at-risk group for HIV in Thailand – particularly in Bangkok, where one in three MSM are estimated to be living with HIV. HIV incidence is also alarmingly high among young MSM aged 18-21, at 12.2 per 100 person years.

An estimated 40% of all new HIV cases between 2012 and 2016 were among Thai MSM – but this group accounted for just 29% of all tests conducted in this time.

While HIV prevalence estimates are less well known among transgender women, estimates from studies have shown it to range anywhere from 10% to 17%.

Of the participants, more than three-quarters self-identified as gay, but more than half of the participants had hidden their sexual identity. Around a quarter had more than five sexual partners in the last six months, and just under half had sometimes or never used a condom in the last six months. Just over a third had reported drug use in the last six months.

Increasing access to HIV testing and uptake of PrEP is a critical priority for Thailand, where the majority of new infections are among key affected populations. But finding at-risk people and linking them to vital services is a challenge.

Innovative interventions such as the O2O model can provide new avenues to reach high-risk MSM and transgender women and other key affected populations who are active online.  

While the intervention took place in Bangkok, the authors state that it can be replicated and scaled-up in other settings where there is already a high internet penetration among key affected populations.

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Written by Caitlin Mahon

Content Specialist - HIV & Sexual Health