Although HIV was only first detected in India in 1986, over the past three and a half decades India has become home to the second largest population of People Living with HIV/AIDS (PLHIV) (2.3 million). Multiple factors contribute to this rapid escalation, making it a public health crisis in the nation.
Even so, HIV is a manageable health impairment if diagnosed, treated and managed correctly. The National AIDS Control Organization (NACO), India’s AIDS response governing body, has several goals in place to ensure that the rising number of cases are curbed, one of which is helping PLHIV adhere to Anti-Retroviral Therapy (ART).
ART makes it possible for people living with HIV to live long and healthy lives, and can even prevent HIV transmission if the HIV viral load becomes undetectable. But for improving the adherence and retention on ART for lifetime, program data and research has proved that the first six months of treatment are critical in terms of habit formation on ART adherence.
In light of this, Everwell, under the guidance of NACO and program leadership from Johns Hopkins University School of Medicine under the USAID/PEPFAR funding, pioneered and conducted a pilot of Self-Verified Adherence, using Everwell’sr 99DOTS technology, supporting newly diagnosed PLHIV. In this pilot, about 1800 newly initiated PLHIV were encouraged to indicate their daily adherence to ART by giving a free call to a toll free number for the first six month of their treatment journey.
The first phase of this pilot was a great success, with an average adherence of ~82%
With the promise of similar (and hopefully better) results, Everwell has commenced the second phase of the pilot (SVA-II). Everwell is acting as the key technical and implementation partner for SVA-II, and we are working alongside several highly respected organizations, including Johns Hopkins University School of Medicine (via Project ACCELERATE funded under USAID/PEPFAR) as the implementing partner, USAID and the National AIDS Control Organization (NACO) as the guiding force for the program. We have also partnered with Piramal Swasthya Medical and Research Institute (PSMRI) that manages NACO’s 1097 helpline number and continue our association with AllianceIndia (Vihaan) to ensure standardized care and counselling to all enrolled on the program.
As per UNAIDS’ 95-95-95 by 2030 strategy, the last ‘95’ refers to PLHIV on ART having suppressed viral loads and adherence above 95%. Our Phase-II pilot is NACO’s effort toward this goal and, to help achieve it, the revised project has been implemented with additional integrations, support mechanisms and revised follow-up protocols.
Three months into the second pilot, Everwell’s technology has been scaled across 50 high burden centers across 17 states with unique geographical and socio-economic challenges. We are already seeing success among both healthcare staff as well as PLHIV – lowering the workload and burden for the former, and assisting in remote care for the latter.
Currently, Everwell’s is the only scaled technology that supports adherence management for PLHIV. We are very excited to support this adherence work in India, and ensure that PLHIV are empowered to lead long and healthy lives.
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