Implementation of digital HIV services in Guangzhou's primary health-care system, China.

Objective: To describe changes in access to voluntary human immunodeficiency virus (HIV) counselling and testing services following the implementation of a mini-application (app) at primary health-care facilities across Guangzhou, China.

Methods: In 2018, the Guangzhou Center for Disease Control and Prevention and the Lingnan Community Support Center co-developed WellTest, a mini-app within the WeChat environment, to address voluntary counselling and testing service needs. The mini-app provides on-demand information for clients, links them to health services, and allows users to provide feedback on health-care quality and share test results with partners. We retrieved data from the National HIV/AIDS Prevention and Control Information System and the app backend to assess adoption and service use after implementation of WellTest in primary health-care facilities in December 2018.

Findings: Between 2018 and 2023, WellTest adoption at primary health-care facilities increased from 1.5% (2/134) to 90.1% (172/191). The annual number of visits for voluntary HIV counselling and testing services at these facilities rose from 7376 to 20 002, representing 83.6% of all 23 930 voluntary HIV counselling and testing visits in 2023, compared with 36.6% (7376/20 129) in 2018. The proportion of newly diagnosed HIV infections at primary health-care facilities increased from 21.7% (187/862) to 50.4% (239/474).

Conclusion: The increased access to HIV services in Guangzhou's primary health-care facilities highlights the value of digital health interventions in addressing service delivery gaps and meeting the needs of providers and clients. Expanding such interventions has the potential to strengthen decentralized health care and disease screening in low-resource settings.