Burnd is an app released by TechHealth Sdn Bhd as a response to the rise of STIs and HIV globally. The app, which is available in 51 countries, uses complex evidence based algorithms to determine one’s objective risk of getting HIV and/or an STI before directing the user to the nearest testing site that fits the user’s age, gender and sexual orientation. They maintain a very extensive network of HIV/STI testing/treatment sites, and locations providing PEP (post-exposure prophylaxis means taking antiretroviral medicines (ART) after being potentially exposed to HIV to prevent becoming infected) in the world spanning across 65 countries. One of their main aims with this app is to ensure that users are able to access PEP in less than 12 hours anywhere they go.
“For the past 5 years I have been volunteering with children and families living with HIV, doing outreach programs and volunteering to conduct anonymous HIV testing for at risk individuals. I have gone as far as driving young people to get tested and have waited with them while they got their results because unfortunately most of them don’t have a support system. I have seen people die of AIDS, children being made orphans because of it and I have helped people who have attempted to take their own lives after getting a positive result. And these experiences including that of seeing grown men breaking down because they don’t know how to handle the fact that they are positive has made me want to do more in the fight against HIV and to end the unfounded discrimination associated with it,” shares Shaik Ashraf, the creator of the app.
During his time at medical school Ashraf was always intrigued at how society and culture can affect the outcome of a disease. He noticed that the common thread among all his discussions with People Living With HIV (PLHIV) and individuals at risk of HIV was the discrimination they faced when getting tested and the misinformation surrounding it. This proved to be yet another great motivation behind creating Burnd.
The app is supposed to act like a one stop centre for anything to do with sexual health. It uses complex latest evidence based algorithms to detect one’s objective risk of HIV and STD before directing the user to the nearest testing/treatment facility that fits their age, gender and sexual orientation/gender identity. “This is very important because majority of the time one’s risk of getting HIV is very subjective and it is influenced by the biases and prejudices one may have. For example, if you are a gay man getting tested in a rather conservative region, any sexual practice will be deemed as high risk because of the prejudices that exist. This algorithm, however, removes anything that can influence your risk profile to give you an objective risk,” Ashraf adds. “The algorithms are extremely sensitive so it will even ask you if you know for certain your partner’s HIV status. And if your answer is yes, it will then ask you if they are negative, positive (on treatment) or positive (not on treatment).” The popular belief is that if you had sex with someone who is positive your risk is immediately high but the evidence suggests that, if they are successfully on treatment they can’t pass the virus to you. All these factors play an important role at deducing your risk level, before which the appropriate risk reduction strategies can be taken.
The app is completely confidential. It does not ask for any kind of personal information. It only asks for the user’s location so that the app can help find the nearest healthcare facility.TechHealth has a zero tolerance policy when it comes to discrimination, which is why they ensure that all the clinics they have listed undergo an intense vetting process. In the case of a single incident of discrimination they ensure that the facility is removed from the network. The stigma and discrimination associated with HIV is very much alive across the globe. In India, despite the historic move to decriminalise same sex relationships, people still face a lot of discrimination. That is why Burnd only directs those that are LGBTQ to LGBTQ friendly healthcare providers who have undergone strict vetting process. “The only way forward to end discrimination is to push for evidence based policies. We need laws to protect PLHIV from discrimination and we need to use evidence based research to fight the stigma of HIV. It is an uphill battle but if we are to ever see a world free from the burden of HIV, it must be done. We have everything we need to end HIV from safer sex practices, to PreP and PEP, and to concepts like Undetectable = Untransmittable and Treatment as Prevention (TasP). What we lack is willpower.”
They also provide rape/sexual assault victims with the support they would need post an assault. They help direct the victim to the nearest healthcare facility that is equipped to hand rape (which includes having a Sexual Assault Nurse Examiner (SANE) or SANE equivalent) at the facility. This feature, however, will only be available in India in about 5 months. “There has been many reports that we have found during our research which talks about victims being turned away because the hospital is not equipped to handle such events. This is not only distressing for the victim but it could discourage the victim from seeking medical help. For us, our main priority is getting women and men who have been sexually assaulted to the nearest ‘eligible’ hospital to get the medical aid they need in the form of treatment of STDs, HIV PEP and emergency contraception if needed followed by proper psychological assessments.” The reason why the feature (to direct users to healthcare facilities which are equipped to handle rape) is not yet available in India is because gathering information has been rather difficult, according to Ashraf. “We are currently in the process of gathering as much information from people on the ground and understanding the laws there.”
Another added service that’s available to both users and non users helping them travel. “If an individual is planning to get tested in a foreign country or if they are HIV positive and are planning to travel with HAART, they can contact me and I will inform them of the policies in that country and the immigration ramifications of a HIV positive test result and/or immigration ramifications of bringing HAART through the border.” A large chunk of their annual profits goes towards funding anonymous testing in countries where being LGBTQ is criminalized. “This way we not only help our users take charge of their sexual health, but we also help those who are less fortunate.” It is important that every LGBTQ person in the world gets access to non-judgmental healthcare. Every download of the app will help some young frightened LGBTQ individual in a country where being LGBTQ is criminalized get tested. “HIV belongs in the history books, not in the present and definitely not in the future. We need to put our best foot forward if we want to see a world free of the burden of HIV. No child should be born with HIV anymore, no child should be made an orphan because of AIDS, no one should be banned from entering a country because of their status and no one should take their lives because of a positive result.”