HIV Care Went Digital During COVID-19: Lessons from Filipino Community Volunteers
Article information
Cebedo, M. C. S., Dela Cruz, F. I. U., Dela Cruz, L. Z. S., Mojica, A. F. Q., & Cleofas, J. V. (2022). The use of ICT in providing HIV services during the COVID-19 pandemic: A qualitative study among Filipino HIV volunteers. Nurse Media Journal of Nursing, 12(2), 258–268. https://doi.org/10.14710/nmjn.v12i2.45753
What this study is about
COVID-19 disrupted many health services, including HIV care. In the Philippines, restrictions on mobility, fear of infection, and overwhelmed health systems made it harder for people to access HIV testing, counseling, medicines, and treatment support. This was especially concerning because the Philippines already had one of the fastest-growing HIV epidemics in the world.
This study asks a practical question: How did Filipino HIV volunteers use information and communication technologies, or ICTs, to continue providing HIV services during the pandemic?
The focus is on volunteers from HIV-focused community-based organizations. These volunteers are crucial because they help link people to testing, counseling, treatment, support, and advocacy. During COVID-19, many of them had to quickly shift from face-to-face service delivery to digital or hybrid forms of care.
Why this matters
HIV care depends on continuity. People need access to testing, counseling, antiretroviral treatment, follow-up, and emotional support. Interruptions can lead to delayed diagnosis, treatment gaps, anxiety, poorer health outcomes, and increased risk of HIV-related complications.
During the pandemic, volunteers and community-based organizations had to innovate fast. Their experience offers lessons for digital health, community health nursing, nursing informatics, and crisis-responsive service delivery.
What the researchers did
This was a qualitative descriptive study involving 16 Filipino HIV volunteers from community-based organizations, hygiene clinics, and related HIV service settings in the National Capital Region. Participants included general volunteers, peer navigators, HIV counselors, HIV/AIDS coordinators, case managers, peer educators, and organizational managers.
The researchers interviewed participants through videoconferencing using a semi-structured guide. They asked about the HIV services volunteers provided, how service delivery changed during the pandemic, what ICT tools were used, and what made these tools helpful or difficult.
The study used inductive qualitative content analysis, meaning the researchers allowed themes to emerge from participants’ accounts. Table 3 in the article summarizes the two main themes: ICT-facilitated solutions and challenges in using ICT for HIV services.
What the study found
1) ICT helped sustain HIV prevention work
Before COVID-19, HIV education often involved face-to-face outreach, seminars, community events, and direct conversations. During the pandemic, these became difficult or impossible. Volunteers shifted many prevention activities online.
They used:
- social media pages for educational campaigns and announcements,
- videoconferencing platforms such as Zoom for HIV seminars and orientations, and
- private messaging apps to answer questions, schedule consultations, and respond to common concerns.
Some organizations even used chatbots to respond to frequently asked questions. This shows how HIV education became more digitally mediated—not only through formal webinars, but also through everyday messaging and social media interactions.
2) ICT helped promote HIV testing
COVID-19 constrained HIV testing because people could not easily travel or access clinics. Volunteers responded by using digital platforms to invite and encourage people to get tested.
Facebook was one major tool. Volunteers used organizational pages, personal accounts, and online groups to promote free HIV testing. Dating apps, especially Grindr, were also used to reach people who may be at higher risk and might be more open to targeted HIV testing promotion. Some volunteers created profiles indicating that they offered free HIV testing and counseling.
This finding is important because it shows that HIV outreach often works best when it meets people where they already are—whether that is Facebook, messaging apps, or dating platforms.
3) ICT supported HIV treatment continuity
For people living with HIV, uninterrupted access to antiretroviral therapy is essential. But during lockdowns, traveling to treatment hubs became difficult and risky. Volunteers used online courier services such as Lalamove and Grab to deliver antiretroviral medicines to clients.
They also used text messages, calls, direct messaging, Twitter, Facebook, and other platforms to coordinate with treatment hubs, doctors, hospitals, and clients. Even basic technologies such as analog calls and SMS remained important, especially in areas with poor internet connectivity.
The key lesson: digital health is not always high-tech. Sometimes, effective ICT care includes simple tools like texting, calling, and coordinating delivery services.
4) ICT became a channel for psychological support
The pandemic increased worry, isolation, and uncertainty for many clients. Some volunteers kept their communication lines open so clients could reach them for emotional support and health concerns. Facebook pages, group chats, photos, and private messages became channels where clients could describe problems and receive reassurance.
This matters because HIV care is not only about medicine. It also involves trust, emotional support, accompaniment, and reducing fear.
The challenges of digital HIV service delivery
1) Not everyone had access
Volunteers noted that some clients lacked phones, internet, devices, or stable connectivity. This digital divide limited who could benefit from online consultations, messaging, or ICT-based care.
This is a major equity issue: if HIV services become digital, people without digital access may be left further behind.
2) Volunteers experienced increased work demands
Digital tools made volunteers more reachable—but sometimes too reachable. Clients could message late at night or outside usual service hours. Volunteers had to manage social media pages, answer private messages, monitor inquiries, coordinate deliveries, and respond to urgent concerns on top of their usual work.
This created blurred boundaries between volunteer work, personal time, and family time. The study links this to the broader issue of technology-related stress.
3) ICT lacked “human touch”
Some volunteers felt that online service delivery was less personal. Face-to-face HIV counseling allows providers to notice gestures, reactions, silence, distress, and subtle emotional cues. Online interactions made it harder to assess clients physically and emotionally, and harder to train new HIV counselors.
The study therefore does not romanticize digital health. ICT helped, but it could not fully replace human presence.
Bottom line
This study shows that Filipino HIV volunteers creatively used ICT to protect continuity of care during COVID-19. Digital tools helped keep HIV prevention, testing promotion, treatment support, medicine delivery, and psychosocial care moving during a crisis. But the study also warns that ICT-based care must address access, workload, privacy, boundaries, and the human side of care.
Policy/practice recommendations
- Codify pandemic innovations into HIV service guidelines
Community-based organizations should document what worked—social media outreach, online counseling workflows, courier delivery, tele-coordination—and turn these into manuals or protocols. - Use hybrid HIV service models
Post-pandemic HIV care should combine online and offline services: digital tools for reach and convenience, face-to-face care for counseling, trust-building, physical assessment, and complex needs. - Protect volunteers from digital overwork
Organizations should set official service hours, assign rotating responders, clarify emergency vs non-emergency channels, and build rest periods into volunteer systems. - Invest in digital access for clients and providers
Government, private partners, and civil society organizations can support devices, internet subscriptions, secure platforms, and digital training for HIV service providers and clients. - Include ICT-based HIV care in nursing informatics education
Nursing students should learn how digital tools can support prevention, testing, treatment coordination, medication delivery, and psychosocial care—especially during public health emergencies. - Design digital HIV services with human connection in mind
Online counseling and telehealth should include practices that preserve warmth, empathy, privacy, and trust, rather than simply transferring face-to-face care into chat boxes.
Glossary of key terms
- ICT / Information and Communication Technology — Digital and communication tools such as social media, messaging apps, videoconferencing, text messaging, calls, dating apps, and courier platforms used to support service delivery.
- HIV services — A broad set of services including HIV prevention education, testing promotion, counseling, treatment support, medication coordination, and psychosocial care.
- PLHIV — People living with HIV.
- Community-based organization (CBO) — A community-rooted organization that provides services, advocacy, and support, often filling gaps in formal health systems.
- HIV volunteer — A professional or non-professional service provider who supports HIV-related care, education, testing, navigation, counseling, or advocacy through a community organization.
- HIV prevention initiatives — Activities that aim to reduce HIV transmission through education, awareness, safer-sex promotion, and community engagement.
- HIV testing promotion — Outreach activities that encourage people to know their HIV status and access testing services.
- Antiretroviral therapy / ART — Medication used by people living with HIV to control the virus and maintain health.
- Treatment service coordination — The work of linking clients with doctors, treatment hubs, medicine supply, counseling, and follow-up care.
- Telemedicine / telehealth — Use of digital or communication technologies to provide health services remotely.
- Nursing informatics — A nursing field focused on using information and communication technologies to improve patient care, service delivery, administration, and health systems.
- Digital divide — Unequal access to internet, devices, digital skills, and reliable connectivity, which can affect who benefits from online services.
- Technostress — Stress caused by technology use, including constant connectivity, blurred boundaries, and increased digital workload.
- Hybrid care — A service model combining online/digital and face-to-face components to balance reach, convenience, and human connection.
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