Background: Physical outreach has been the main prevention approach for key populations (KP) in HIV programs, but is often costly and limited in its capacity to reach geographically dispersed, criminalized, stigmatized, or otherwise “hidden” KP. The use of mobile and internet technologies is a promising approach for young tech-savvy users with internet access. However, the conduct of virtual outreach among KP with low literacy or limited social media or Internet access remains challenging. The use of telephone-based Interactive Voice Response (IVR) systems may help overcome these barriers by supporting keypad-based interactions that require no advance knowledge on the part of end-users and can be accessed by mobile phone virtually anywhere.
Description: A four-digit, easy to remember, free of charge call number (1295), was linked to the VerboiceÒ free and open-source IVR and was promoted through leaflets and social media targeting KPs. A variety of services are available to callers via self-guided menu items, including health information via quizzes and short messages; edutainment using mini-dramas, songs, and testimonials; and, online live counseling. The system also provided an option for callers to register to receive HIV-related voice-message reminders monthly.
Lessons learned: Between September 2015 and November 2017, 55,877 calls were received​​ from 8,027 unique telephone numbers registered. These included 22,809 calls where users opted to receive content relevant to entertainment workers (EW) (40.82%); 17,704 calls selecting content relevant to men who have sex with men (MSM) (31.68%); and 15,364 calls selecting content relevant to transgender (TG) people (27.50%). Edutainment was the most popular service selected, accessed 34,043 times or (60.92%) of the total calls. Approximately 13,204 users chose health information (23.63%), and online-counseling was accessed by 8,630 (15.44%). During the same period, 145,075 reminder messages were sent to numbers registered under the EW option; 132,520 for MSM; and, 29,415 for TG.
Conclusions/Next steps: IVR systems are a viable approach to providing KP with essential HIV-related information and bridging the digital divide. However, in adopting IVR it is also essential to establish online-to-offline referral systems to facilitate and document the connections to HIV testing and treatment services needed to accelerate epidemic control.

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