Taking HIV Care Online

A sexual health manager at Safe Zindagi explains the HIV self-testing process to a client. (Photograph courtesy Safe Zindagi)

At-risk HIV communities reluctant to access in-person services are often unaware of online resources, where they have the advantage of anonymity. Safe Zindagi, an online portal funded by the U.S. Agency for International Development (USAID) and the U.S. President’s Emergency Plan For AIDS Relief (PEPFAR), provides HIV care and services to hard-to-reach populations in India. The platform is implemented through Project ACCELERATE, in partnership with India’s National AIDS Control Organization.

Safe Zindagi has a team of trained sexual health managers to answer questions in person and remotely, offering counseling and linking users with doctors and health centers. The platform is active in 23 cities across India and headquartered in New Delhi.

Safe spaces

Dia, a transgender woman, has been a sexual health manager at Safe Zindagi for over two years. She used social media to share her struggles and connect with the transgender community. “I am now able to share my own stories, personal experiences and struggles through social media, which has also led to the realization that there are many who struggle like me,” she says. “I have used the Safe Zindagi platform to educate people regarding safe sex practices, risks of unprotected sex, and to create a support space for those who are struggling.”

Safe online platforms are especially crucial for trans women to share their stories, she says. “If we are unable to locate safe spaces, then it stifles our creativity, freedom, and the very human nature to talk, engage and share.”

Easy access

Arjun (name changed), a 25-year-old transgender man, is a friend of one of the sexual health managers at Safe Zindagi who helped him access the site and place an order for an HIV self-testing kit. For him, accessing Safe Zindagi’s resources was easier than going to a clinic or a lab.

After getting tested, Arjun went through the Safe Zindagi social media handles and found testimonials on HIV services. “The short experience-sharing videos were very interactive. In a way, they answer your queries on testing and the procedures afterward,” he says.

Community challenges

Bobby (name changed), a chef and a transgender woman, wanted to know more about HIV and sexually-transmitted infections. She used the Safe Zindagi portal to book an HIV self-testing kit and scheduled an interaction with a virtual counselor. Bobby has been hesitant about exploring other online platforms or facilities. “The LGBTQIA+ community’s challenges are not the same as what others face,” she explains. “This needs to be resolved and addressed with sensitivity, which requires accurate knowledge about our community.”

Preventative measures

Tulsi (name changed) is a 30-year-old transgender sex worker, who accessed the Safe Zindagi portal for the first time to order HIV testing. This was also when she was introduced to HIV self-testing kits. After her results came back negative, her sexual health manager introduced her to Safe Zindagi’s PrEP (pre-exposure prophylaxis) manager.

“My counselor told me about the option of PrEP to prevent HIV and asked me to use it in addition to condoms,” she explains. “I needed more information about this and was promptly linked to Safe Zindagi’s PrEP manager,” she recollects.

Safe Zindagi provides PrEP to eligible candidates at subsidized rates. This makes the medication affordable for users like Tulsi, who says she is happy with the platform and has referred five of her friends to Safe Zindagi. “Availability of services like Safe Zindagi can increase awareness about these options to the mainstream community,” she says.

Jason Chiang is a freelance writer based in Silver Lake, Los Angeles.

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