Abstract Body

Globally, populations at risk continue to evolve, but HIV testing approaches have remained largely stagnant. Specifically, penetration of the internet and anonymity of online ‘hook-up’ platforms have led clients to seek partners in virtual vs. physical spaces; these individuals are not reached by traditional HIV testing approaches. We present findings from a virtual outreach program for education and HIV service linkage.

We established a team of virtual outreach workers (vORW) who reached potential clients via online dating (e.g., Grindr) and social media platforms. They chatted with clients, promoted safe sex practices and assisted in booking an HIV test via an online testing platform. Clients had to be ? 18 years old and complete a risk assessment before booking a test at a physical site. vORWs assisted clients testing positive with confirmatory testing and ART linkage. Process measures across the testing continuum were captured. Correlates of a positive screening test were explored using logistic regression.

From Oct 2019-Sep 2021, 9,355 HIV testing reservations were made across 22 Indian states. Median age was 29; 94% were male, 4% female and 2% transgender. Most (83%) identified as men who have sex with men (MSM). Three quarters of clients reported no prior HIV test. In the last 6 months, 85% reported condomless sex, 44% multiple sex partners and 12% substance use before sex. Of 9,355 reservations, 6,839 (73%) screening tests were completed and 491 (7%) screened HIV positive of whom only 27% had previously been tested (Figure). Positivity varied by region (2% in West to 8% in North). Among those who screened positive, 76% had confirmatory testing, of whom 99% were confirmed positive and 69% initiated ART. Those with no prior HIV test were less likely to get a confirmatory test and initiate ART. Factors significantly associated with a positive screening test were being male (aOR 3.02), reporting sex with men/women only (no transgender partners) (aOR 1.62), recent needle sharing (aOR 3.63) and positive syphilis test (aOR 2.78).

These results highlight the feasibility and effectiveness of a vORW approach coupled with an online testing platform to reach a high-risk population, the vast majority of whom had not been reached by traditional HIV programming. Additional effort may be needed to link those new to HIV services to ART and move closer to 95-95-95 targets.