Online dating has undoubtedly upped the risk of HIV among the group that has shifted from traditional spaces to virtual platforms which are difficult to track. Estimating the size of these groups and planning interventions to curtail the risk of HIV can be challenging. “But a start can be made by building in regulatory pop-up messages for every dating app and website so that the user gets to know about unsafe sex and quick tips for safer sex practices,” says Dr Sheela Godbole, Director- Indian Council of Medical Research – National AIDS Research Institute (ICMR-NARI).
Safety of online dating sites for vulnerable population groups
ICMR-NARI has developed some guidelines for reaching populations in virtual spaces for research and surveillance purposes. In this guide they have suggested steps that could be used for mapping FSWs and MSMs who are operating on virtual platforms. “We have suggested different approaches that could be adopted for delivering HIV interventions in the country. These approaches need to be pilot-tested,” says Dr Godbole. This guide was developed through a desk review and various consultations with programme officials, experts, civil society organisations and key populations and is now available in the public domain, says Dr Amrita Rao, scientist at ICMR-NARI.
“Regarding online dating apps and websites, we can have ‘regulatory’ pop-up message for every user upon login regarding risks of unsafe sex and quick tips about safer sex practices. This can be done along the lines of the messaging that we have on cigarette packets,” says Dr Godbole. It is important to incorporate certain standards that are also used globally. For example, the US Centers for Disease Control (CDC) talks about full disclosure before getting into an intimate relationship, keeping an undetectable viral load so that you cannot pass HIV to your partner and taking PrEP (pre-exposure prophylaxis) medicine by people at risk for HIV.
Need to check state-specific data and devise strategies
Brothels, dance bars, hangouts, truck halt points and many other locations become logical choices as sites for outreach interventions, says Dr Samiran Panda, distinguished scientist chair, ICMR. He has written the “Basic Guide to Mapping, Size Estimation and Risk Behaviour Among Key Populations in Virtual Space.” Anonymity and broader accessibility could be some of the reasons for people to shift to virtual spaces and understanding the nuances around these changes is critical for the success of future HIV interventions, says he. He’s worried about an upsurge in HIV infections in states like Mizoram, Tripura, Chhattisgarh, Arunachal Pradesh for instance despite a decline in numbers in a countrywide summary.
LGBTQI activists say that traditional targeted interventions no longer work
Bindumadhav Khire, LGBTQI activist and Director of Bindu Queer Rights Foundation, admits that physical spaces in urban areas where people met has almost disappeared. “In these virtual spaces, people anonymously hook up with strangers and even tend to get exploited. Sometimes they get robbed on the pretence of a meet-up. It is also becoming extremely difficult for NGOs to reach out to these persons for educating them on safe sex issues,” says he. “In Maharashtra we have urged the State AIDS Control Society to change the traditional model of targeted intervention. Very little effort is made to capture the new generation community members as most have never engaged in the habit of seeking physical spaces and instead network extensively on online platforms. Hence for educating people on safe sex and to provide information related to condoms and inculcate health-seeking behaviour, it is important for a one-on-one contact with peer educators,” Khire says. While the internet itself has guides to safe sex, people take unwarranted risks, he adds.
Key risk groups of concern and what is being done in these areas in terms of awareness and counselling on HIV
The key risk groups of concern vis-à-vis HIV are the vulnerable populations such as Persons Who Inject Drugs (PWID), MSM (Men Who Have Sex With Men), TG (transgender) and FSW (female sex workers). Specific governmental programmes enable various NGOs to provide prevention education, counselling, testing and treatment for sexually transmitted infections. Truckers and migrants also receive attention and preventive intervention. Vulnerable populations are provided free HIV counselling, testing and care services through these clinics. “Societal stigmatisation of different kinds of sexual behaviours, including transactional sex, is among one of the reasons why people, who might be at risk and may want or need to know their status, hesitate to approach HIV testing or antiretroviral treatment centres, for fear of being recognised. We need to focus and repurpose the delivery systems to embrace these challenges and provide an enabling environment for the same,” says Dr Godbole. In India, it is estimated about 23.19 lakh are expected to be living with HIV, including 81,000 children.