The COVID-19 pandemic brought many disruptions to the health system with marked effect on the HIV care and treatment continuum causing reduction in clinic visits and in-person client engagement. Lagos, the most populous city in Nigeria, was the worst hit by the COVID-19 pandemic with 40% of total cases reported in Nigeria. There are 27,345 people living with HIV on treatment in program-supported sites. This presented a challenge to continuity in HIV treatment and viral suppression.
Leveraging a smartphone technology, we developed and deployed the Jolly-95 App, an innovative strategy in engaging HIV clients to mitigate interruptions in treatment. The Jolly-95 App is a self-service mobile app designed to sustain patient engagement in care and improve access to HIV support services. Patients with mobile phones were encouraged to sign up for the app to gain access to app features which includes patient treatment information (ARV regimen, current viral load), appointment scheduling, selfcare management, in-app chat, and facilitated referrals to support services. Trained client service operatives provide real time support for in-app request and messaging, with end-to-end encryption to ensure data security.
After 33 weeks of pilot implementation (Feb 10th to September 29th, 2022), 1,672 (26%) of 6,381 clients who visited the clinic were assisted to download the app. All (100%) had logged in at least once to activate the appointment reminder features. There were more female (69%) than male (31%) among the users. The greatest proportion (37%) of the users were between age 40-49 years and the lowest (8%) were between ages 10-29 years.
The in-app chat was the most commonly used feature (86%). Feedback via in-app chat showed that clients found the app relevant to their care and made remote access to HIV services easier. Of the 1,672 users, 1,573 (94%) were still active in treatment six months after downloading the app. Of 1,044 eligible users who had viral load tests done during the review period, 982 (94%) were virally suppressed. Limitations encountered in utilization included privacy concerns expressed among clients; and prohibitive data cost to clients.
Opportunities: Integrating the Jolly-95 app into the HIV program can enhance patient-centered care and service quality which will result in improved patient outcomes including continuity in treatment.
