Improving Sexual Health through AI

A culture of silence, blame the victim attitudes and stigma prevents a lot of persons from seeking sexual health care - children are reluctant to talk to their parents and teachers about their sexual health and HIV, leading to episodes of unwanted sexual infections, and teenage pregnancies. In Ghana, a recent report by the Council on Foreign Relations indicates 14% of Ghanaian girls are victims of sexual abuse. That is over 700,000 girls experiencing trauma and suffering in silence.

Mmore than half have experienced gender-based violence. 3 out of 4 new HIV infections are among young girls, and the prevalance of HIV among men who have sex with men is markedly higher (18%) than the national average (2%). The situation is not getting better. 

In line with the UN HIV 90-90-90 goals, we utilize artificial intelligence to attract, educate and train young children and adolescents about HIV and their sexual health, and by so doing help to connect them anonymously to sexual care providers as well as HIV testing and treatment facilities that we have identified and work with.  

We utilize advertisements to common social media sites to attract young persons to our website (www.ahnonymous.org). On our website, we deploy a chatbot solution that engages visitors, and encourages them to learn more about their sexual health and HIV using a set of pre-populated questions and answers on HIV. Through this technology, we also allow individuals to connect with specialists, if they desire, and facilitate linkages with sexual health and HIV care providers. The second component of our solution maximizes a most prefered cultural norm, in-person interactions, by providing a physical space for persons who may not have access to digital technology to access our services. Here, we use digital design training to attract young persons to our center, train them in the use of digital design and bead making using Canva, and use the opportunity to teach them about their sexual and reproductive health, driven by certified youth trainers. 

According to a recent report by the Council on Foreign Relations, 14% of Ghanaian girls are victims of sexual abuse, and more than half have experienced gender-based violence. 3 out of 4 new HIV infections are among young girls, and the prevalence of HIV among men who have sex with men is markedly higher (18%) than the national average. 

Our digital solution targets at-risk youth, through targeted advertisements and recruitment strategies, to provide them with crucial information that can enable them to protect their sexual health, limiting HIV transmission through prevention, early detection and treatment using artificial intelligence.

To complement our digital solution, we employ a technique to de-stigmatize the delivery of sexual health information through:

• Provision of a safe, judgement-free space
• Youth delivered information and programming using youth trainers to coach their fellow young people . This promotes a community where young people can build trust and feel accepted among their peers. We offer educational resources and Skills-based workshops including digital design and bead-making

Our team consists of a diverse set of individuals with different life experiences, diverse backgrounds and sexual orientations. . Our founder is a trained medical doctor, a recognised Sexual and Reproductive Health advocate, with over 5 years of experience in his youth advocacy work. Our chair of community engagement is an OB/Gyn resident, who continues to use  her training to provide care for young girls affected by different sexual and reproductive health issues, our youth trainers consist of young individuals who were born and grew up in the community within which they serve, and have themselves had different experiences that enable them to understand the community needs. Implementation of our solution has been community-led at every step of the way - we have engaged with children and caregivers in several communities in Kumasi, Ghana’s second-largest city, to better understand the drivers of stigma, sexual health neglect and HIV in the community, and how the community believes this could be improved. We have gathered this data, along with many youth and stakeholder consultations to inform the development of our chatbot to enhance sexual and HIV training and care-seeking behaviour.

We have committed a significant amount of resources and time to build and develop this product. Our acceptance as a solver will enable us to have access to funding that can guarantee a 5-10 year sustainability of our low-cost services, and the potential to transform our services into a global solution led by our team of experts. We desire to have access to a diverse netowrk of mentors, coaches and guides who can direct us on how to improve our innovation, position ourselves well on the market and help us to develop an effective monitoring and evaluation framework to maximize the impact of our work. 

We utilize Artificial Intelligence in the form of a chatbot to compile and answer common questions about sexual health and HIV to adolescents in Ghana. Sexual Health and HIV/AIDS are a hugely stigmatized subjects in Ghana, and many people are reluctant to discuss them, much less ask questions about them.  Currently, the HIV prevalence rate in Ghana is 2.1%, however, this figure is markedly elevated among Men who have sex with Men (17%). 

By providing a platform where a chatbot is able to provide evidenced-based information about sexual health and HIV/AIDS through a computer/phone, we ensure anonymity for young children and adolescents, who desire to know more about this, particularly those with same-sex attractions who are at a higher risk. Again, through this chatbot, we are able to further connect persons who require HIV care and other sexual health services to care providers in an anonymous manner, to facilitate care-seeking behaviour and treatment compliance. 

Our aim is to deploy our chatbot through adverts on diverse messaging apps such as Instagram, Facebook, Grindr and jack'd to enable reach to persons needing HIV information the most such as young boys who have sex with men/young boys. We expect that with time, we could adapt this chatbot into local languages and deploy it beyond HIV/AIDS to discuss other stigmatized health topics such as Sexual abuse, adolescent sexual development and LGBT issues using sound and video-based technologies.

Our goals though modified, are in line with the UN 90-90-90 goals on HIV/AIDS eradication: 

- To develop and deploy chatbots in at least 5 local languages that detect questions and deliver information using sound and video technology to reach persons who may not be able to read and/or write. 

- To reach over 5 million young persons in Ghana over the next 5 years, through our mobile/internet technology, to provide them with well informed Sexual and Reproductive Health Information, including HIV/AIDS.

- To reach approximately 90% of young persons at risk of HIV to provide them with HIV prevention information and connect them to anonymous testing and care provision sites to enhance knowledge of their HIV status, treatment initiation, and retention on treatment with undetectable viral loads. 

To measure our goals, we measure traffic on our website. Our chatbot is able to track the number of new users and returning users, the types of questions being frequently asked, the rate of satisfaction of users of the app, and eventually their sexual orientation and HIV status if they are willing to disclose. We also track the number of users requesting to interact with a human and the reasons for which they may want to do so. 

This allows us to have a rough idea of the prevalence of HIV among our users and correlate it to their sexual orientation through data-driven analysis, to provide informed and targeted solutions to reduce HIV among those at highest risk. 

Again, we have data on young persons who reach out to us through our anonymous messaging services, and aim to employ a close the loop technique to measure how many of these individuals access the care we link them to.

The current state of girls and boys in our community is a lack of knowledge about the sexual and reproductive health, with poor decision making skills about their sexual health. Our activities (use of targeted advertisements on diverse social media sites) recruit young persons to our website. Once on our website, a chatbot detects human presence and pops up to start engaging them. Users, intrigued by the presence of the chatbot, begin to engage with it and discover that they are able to access a wide range of easy to read and understand information on their sexual health provided by the chatbot. They have the ability to explore different pathways of questioning using the logic provided by the chatbot, and by so doing, demonstrate again new knowledge, reinforce their old knowledge, or correct their previously incorrect knowledge. Through the chatbot logic, users at high risk of sexual abuse, HIV infection or teenage pregnancy are detected and offered access to a counsellor, who instantly connects and engages the user using an app on their phone. Based on the needs of the user, the counsellor provides needed services immediately, requests to follow up with the user, or connects the user to a care provider within our network. The user is able to access stigma-free sexual health and/or HIV care. They test and know their HIV status, receive sexual abuse prevention training, or receive resources on preventing unwanted pregnancies. They are happier and have confidence in their sexual health status and ability make informed sex choices to prevent unwanted pregnancies and infections. The rates of HIV/AIDS, sexual violence and teenage pregnancies reduce. Young girls and boys are in good health, able to pursue their education and careers and contribute to building a healthy country.

We use Artificial Intelligence, in the form of a chatbot on our website (www.ahnonymous.org). This chatbot is pre-populated with a host of commonly asked questions about sexual health and HIV/AIDS and provides evidence-based answers to them using simple, easy to understand language

This reduces the human burden in interacting with site visitors and provides timely responses to questions asked by visitors of the site. The chatbot detects when someone requires to speak with a human and connects the person instantly to any of our counsellors on standby through an app on their phones.

Our team comprises persons of different gender, sexual orientations and races. We value equity, and encourage persons with the least access to opportunities to work with us. Our team is working to increase access to our services for persons with disability, and for this reason, we have created a physical space where we can attract, train and retain persons with disability in youth advocacy, technical and vocational skills. We ensure that every team member onboarded is receptive to the identities, needs and culture of our users and other team members, and offer training and resources to reinforce, enhance and sustain this. 

We are a market intermediary, and act as middle men between young children and adolescents, and Sexual and Reproductive/HIV care providers in Ghana. Through our unique chatbot application deployed on our website (www.ahnonymous.org), we provide visitors to our site, the opportunity to learn more about HIV/AIDS at their own pace, giving them the chance to decide how they want to be known, and when they want to interact with a human. We then provide linkages to counsellors, HIV testing facilities and care providers who provide stigma-free services, to enhance compliance to testing and treatment. Children and young persons are curious, however, they are reluctant to seek information from openly labelled sexual health centres. When they come across our advertisements on Instagram, they are more likely to click it and be sent to our website, where a chatbot pops up and begins to engage them. We give these kids the opportunity to allow us to contact them, which we do through their caregivers, and enrol them into our physical centre to learn about their sexual and reproductive health while learning a skill. As such we provide a better, healthier life for kids while reducing rates of HIV, increasing rates of HIV treatment, and empowering people with skills to make them employable and improve their livelihoods.

Self-funding stage

Our team began with the self-funding stage, where we self-funded the company registration, website development and hosting, and chatbot development. The entire process cost approximately $5000, supported by a donation of $1000. To reduce costs, we have trained two of our team members in website maintenance, and require minimal external assistance. 

Grant funding stage

We have been supported with a grant of $30,000 from the Social Innovation and Change Initiative at the Harvard Kennedy School, which has enabled us to hire 4 full-time staff, obtain a working space and purchase educational materials to help us with our work. We have invested $10000 of this grant into treasury bills, after deducting our yearly overhead costs, to provide us with a turnover as we seek additional sources of funding. 

Seed funding stage

We are now in the seed funding stage, where we are seeking angel investors who are interested in our cause, as well as other sources of non-dilutive funding to the sum of $75,000. As we seek funding, we will continue to invest any excesses we have in treasury bills, and mutual funds, to be retrieved as necessary. Again, we have invested in a centre to complement our digital work, where we are training young persons in vocational skills such as bead-making and digital design using Canva. We hope that through this, we will be able to develop and sell products that will be re-invested into supporting the activities at the centre and digitally to which all our members have free access.

We have raised over $8000 through self-funding and crowdfunding. We also received a grant of $2000 from the Harvard Innovation Labs, $30,000 from the Social Innovation and Change Initiative, $2500 from the Rose service Learning Fellowship at the Harvard School of Public Health, making a combined $42,500. We are now at the stage where we seek non-dilutive funding to ensure the sustainability of our work over the next 5 - 10 years.