In India, transgendered persons and men who have sex with men often face stigma and discrimination that can prevent them from accessing HIV prevention and treatment services. The National AIDS Control Organization provides basic, targeted intervention services for men who have sex with men. But, many men who have sex with men remain hidden from society and do not register for these services or visit drop-in centers. Transgendered persons and men who have sex with men are difficult to reach, despite the pressing need: The national average HIV prevalence among men who have sex with men is 4.4 percent, about 13 times higher than that for the general population (0.35 percent).

FHI 360 conducted a project in India, called Sahaay, to test the efficacy of an innovative mHealth-based model, centered on a helpline, to reach transgendered persons and men who have sex with men. Sahaay was funded by the Department of Foreign Affairs, Trade and Development Canada through PATH. (Read the study.)

Launching the helpline

In September 2013, the Sahaay helpline became India’s first dedicated helpline for transgendered persons and men who have sex with men. The toll-free confidential helpline, open 24 hours every day, offered callers information and counseling on HIV and AIDS, sexually transmitted infections (STIs), general health and psychosocial issues, and relevant legal issues. The helpline targeted transgendered persons and men who have sex with men who either did not want to declare their identity in a face-to-face interaction or did not have access to the government’s targeted intervention services. The helpline was accessible from any mobile or fixed phone network within or outside of India.

The results

The helpline reported an overwhelming response. In nine months of operation, the helpline received more than 100,000 calls, of which 39,800 were from unique callers, bringing the project close to reaching its ambitious target of 50,000 unique users. The number of repeat callers was 18,404, which indicates that the callers were satisfied with the services they received. Counselors also reported that some callers mentioned how the service had benefited them.

An analysis of the calls revealed that 93 percent were primarily for information and 27 percent were mainly for counseling. Of the information-seeking calls, 80 percent were on topics related to HIV and other sexually transmitted infections, while counseling calls focused on psychosocial issues, such as struggles with sexual identity and family pressure to marry.