Digital health intervention reconnects war-affected people living with HIV to healthcare: Ukraine case study

The unprovoked full-scale invasion of Ukraine in February 2022 severely damaged the national health system, disconnecting thousands of people living with human immunodeficiency virus (PLHIV) from essential health services. Digital health interventions (DHIs) offer the potential to reconnect war-affected PLHIV to healthcare and improve health system resilience in case of emergencies. This study aimed to present a comprehensive case study of the implementation and lessons learned from a DHI aimed at reconnecting Ukrainian PLHIV to healthcare in the context of war. A DHI called '#ARTporuch' was implemented in Ukraine in response to the war-related challenges for PLHIV. The case study methodology was used to present the DHI's life cycle, from creation to maintenance. Usage and geographic coverage data were analyzed descriptively. The multi-component DHI, consisting of a website, chatbot, database and information campaign, was implemented. The case study yielded pivotal insights into the DHI lifecycle, including rapid conceptualization, security considerations, agile implementation and continuous adaptation. The online advertising generated >10 million impressions within the information campaign. The website attracted 20 619 visitors, while the chatbot was activated by 2950 users. This case study underscores the potential of DHI as a crisis-response component to reconnect PLHIV to healthcare during wartime. While quantitative evidence of effectiveness is limited due to wartime constraints, the study provides insights into the implementation of DHI in conflict-affected or resource-constrained settings, contributing to the ongoing efforts to achieve universal health coverage and enhance health system resilience planning.