Table 1 Recommendations for the equitable integration of DHIs across steps of the HIV Care Cascade

1

Scale-up and support interoperable health information systems through networks of partners (e.g., public and private health system administrators, device manufacturers, pharmacies).

^7,17

2

Meaningfully involve PLHIV in the design of DHIs to address privacy concerns (e.g., confidential communication channels that provide PLHIV with a space to talk openly and safely).

¹⁹

3

Prioritize research that assesses the quality of DHIs with PLHIV users.

¹⁷

4

Provide widespread and affordable internet access (e.g., WiFi and data plans).

^17,18

5

Develop an international regulatory framework to ensure secure and equitable access to DHIs.

¹⁷

6

Micro-target at-risk communities with outreach efforts on HIV education, prevention, and testing services through DHIs.

^25,26,27

7

Use artificial intelligence (AI) to develop HIV prevention interventions (e.g., HIV risk prediction, social network mapping).

^26,27

8

Use DHIs to promote uptake and to facilitate access to pre-exposure prophylaxis (PrEP) among key populations.

⁶

9

Leverage real-time data collection and predictive machine learning to support a syndromic approach to early HIV detection.

^26,27

10

Offer digital options to order self-testing kits free-of-charge.

²⁵

11

Invest in digital tools to aid personalised HIV treatment initiation and adherence support.

²⁸

12

Invest in digital tools to aid HIV service awareness and access (e.g., maps with pinpoints for HIV services and organizations).

²⁸

13

Enhance community-based linkage-to-care with digital and virtual support networks.

^6,29

14

Invest in tools to enhance linkage to services beyond HIV-related needs, which are known to impact one’s HIV management and long-term well-being (e.g., resources for finding jobs, housing, and language-learning services).

^4,30

15

Implement remote monitoring interventions that use patient-reported outcome and experience measures (PROMs/PREMs) to better identify and respond to clients’ challenges and concerns.

^15,31

16

Invest in the development and integration of chatbots and other AI tools to support HIV self-management and to reduce burden on health personnel.

³²

17

Offer optional telemedicine services to improve follow-up between clients and health professionals.

^20,22

18

Offer digitalised access to mental health services, including virtual therapy or counselling services.

²⁸

19

Use machine learning algorithms to predict poor viral load and CD4 outcomes to inform care management practices.

³³