Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Editorial
. 2017 Jan 1;3(1):15-23.
doi: 10.1016/S2055-6640(20)30293-4.

Implementation of an online HIV prevention and treatment cascade in Thai men who have sex with men and transgender women using Adam's Love Electronic Health Record system

Tarandeep Anand  1 , Chattiya Nitpolprasert  1 , Stephen J Kerr  2 , Tanakorn Apornpong  3 , Jintanat Ananworanich  4 , Praphan Phanuphak  5 , Nittaya Phanuphak  1
Affiliations
Editorial

Implementation of an online HIV prevention and treatment cascade in Thai men who have sex with men and transgender women using Adam's Love Electronic Health Record system

Tarandeep Anand et al. J Virus Erad. .

Abstract

Objectives: Electronic health record (EHR) systems have been infrequently used to support HIV service delivery models to optimise HIV prevention and treatment cascades. We have studied the implementation, uptake and use of an EHR among Thai men who have sex with men (MSM) and transgender (TG) women.

Methods: Participants, e-counselled via the Adam's Love ( www.adamslove.org) support platforms, after having completed risk behaviour questionnaires and being assessed for their HIV risk by online counsellors, were enrolled based on their preference into one of three EHR-supported arms: (1) private clinic-based HIV testing and counselling (HTC); (2) online pretest counselling and private clinic-based HIV testing (hybrid); and (3) online supervised HIV self-testing and counselling (eHTC).

Results: Between December 2015 and May 2016, of a total of 489 MSM and TG women were introduced to the study, 186 (38%) enrolled into the study, with 89, 72 and 25 participants joining the HTC, hybrid and eHTC arms, respectively. Seeking sex online was reported by 83.9%. HIV prevalence was highest (16%) in the eHTC arm, and participants in this arm were more likely to be younger (median age 25 vs 29 vs 27 years; P=0.01), bisexual (16% vs 9.7% vs 5.6%; P=0.005), with an unknown history of HIV or first-time HIV testers (48% vs 25% vs 19.1%; P=0.01) or had tested >1 year ago (15.8% vs 4.8% vs 3.4%, P=0.04), compared with those in the hybrid and HTC arms. Around half (48.3%) of them revisited the EHR at least once to access laboratory results, read post-test summaries and make an appointment for another HIV test. The participants in the eHTC arm had reduced odds of revisiting the EHR twice or more as compared with participants in the HTC [odds ratio (OR) 0.14, 95% confidence interval (CI) 0.03-0.67, P=0.01] and hybrid arms (OR 0.10, 95% CI 0.02-0.44, P=0.003). Overall the EHR satisfaction was high at 4.4 (SD 0.68) on a Likert scale of 5.

Conclusions: Young and high-risk MSM and some TG women engaged successfully with the Adam's Love EHR system, showing its potential to support innovative service delivery models and target hard-to-reach and vulnerable populations.

Keywords: Electronic health record; HIV prevention and treatment cascade; HIV testing; Thailand; health informatics; men who have sex with men; transgender women.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Adam's Love Electronic Health Record (EHR) features and functions
Figure 2.
Figure 2.
Adam's Love Electronic Health Record (EHR) advanced data security system and one-time password (OTP) verification. Advanced security features included an email verification process and a two-factor authentication (2FA) ensured by an OTP for real-time validation during the registration process and each time participants accessed clinical and laboratory test results
See this image and copyright information in PMC

References

    1. Griensven F, Varangrat A, Wimonsate W et al. . Trends in HIV prevalence, estimated HIV incidence, and risk behavior among men who have sex with men in Bangkok, Thailand, 2003–2007. J Acquir Immune Defic Syndr 2010; 53: 234– 239. - PubMed
    1. Ananworanich J, Chitwarakorn A, Wimonsate W et al. . HIV and syphilis infection among men who have sex with men – Bangkok, 2005–2011. MMWR Morb Mortal Wkly Rep 2013; 62: 558. - PMC - PubMed
    1. UNAIDS Smart investments. 2013. Available at: www.unaids.org/sites/default/files/media_asset/20131130_smart-investment... ( accessed December 2016).
    1. National AIDS Committee Thailand AIDS Response Progress Report 2012 reporting period: 2010–2011. 2012. Available at: www.aidsdatahub.org/sites/default/files/documents/UNGASS_2012_Thailand_N....
    1. Wolf RC. Thailand global fund round 8 external evaluation: men who have sex with men (MSM). 2012. Available at: www.researchgate.net/publication/260293958_Thailand_Global_Fund_Round_8_... ( accessed December 2016).

Publication types

LinkOut - more resources