Versatile Options for HIV Support

by Alejandra Cabrera, Regional Strategic Communications, PASMO

Peter’s eyes nervously scanned his Facebook search results for a page that looked familiar or helpful.

Peter had just returned to Nicaragua a few months earlier, and he was almost out of the antiretroviral therapy (ART) medications he had received in Costa Rica. He was afraid of the consequences of abandoning his treatment again.

Peter’s parents took him to Costa Rica when he was seven years old. It was there that he was diagnosed with HIV at age 20.

“I took my medication for a while, but I stopped. I was bored of taking pills every day, but I had no idea how sick I would be.” Peter describes the memory with a lot of pain.  “My own mother could barely recognize me in the hospital bed.”

In 2018, 28-year-old Peter and his family were struggling financially and returned to Nicaragua amidst political turmoil and protests.  His memory of his time in the hospital was still fresh, and he feared not being able to continue his treatment regimen. He spent his first several weeks back in the country searching the internet for a place where he could find support.  During one of his searches, Peter discovered a Facebook Fan Page called “Versátil”, a code word used in the gay community to describe themselves. The Fan Page was a new social media initiative created by the Pan American Social Marketing Organization (PASMO), PSI’s network member, under USAID’s Combination Prevention Program to help increase access to HIV services for young and at-risk men who have sex with men (MSM) in Central America. The program provides these groups with key information and services around HIV testing and counseling, and linkage to care if HIV positive.

When Peter saw the colorful Versátil logo—and its relatable name—he decided to send a private message:

Good morning. I’d like information so I can continue with my treatment. I’m HIV positive and I know the consequences of abandoning antiretroviral therapy. I almost died, but the current situation in my country leaves me without much hope to continue with my treatment. Can you give me information about where I can go?

He quickly received a reply assuring him he would receive help, and Peter agreed for a Combination Prevention Program counselor via WhatsApp. The counselor helped him set up an appointment to visit a local comprehensive care clinic.

Peter is one of more than 1,000 at-risk Nicaraguan MSM and transgender women the Combination Prevention Program has reached through online interventions, including referrals from the Versátil Facebook Fan Page and Instagram account. Online outreach became an important option of Nicaraguans during the political crisis and subsequent violence.  Across Central America, 37 percent of MSM and transgender women who were reached online received HIV testing and counseling. One of every 14 tests had a reactive result, with an estimated HIV prevalence of seven percent, and 77 percent of the positive cases were linked to comprehensive care services and treatment.

In order to contribute to the global “90-90-90 goals”—90 percent of HIV positive individuals know their status, 90 percent of those who know their status are on antiretroviral therapy medication and 90 percent reach viral load suppression—the Combination Prevention Program devised innovative social media strategies such as “Versátil” and segmented online advertising. Cyber-educators also worked closely with field-based counselors to ensure young men like Peter could find a community of support for improved health.

“I didn’t know [Nicaragua’s capital city of] Managua very well. Had it not been for Versátil, I don’t know what I would have done”, says Peter about accessing the HIV care he needed. With a new positive outlook and the support he needs, Peter is working to rebuild his life in an unfamiliar country.

Banner image courtesy of Alejandra Cabrera

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