 All right, so moving on, I would now, it's a great pleasure that I would like to introduce Rizka and Rizka is a doctoral student in public health in Sibelius Maret University in Indonesia. She's a lecturer, researcher, author and complementary in alternative therapy midwifery practitioner. Her research interests include maternal and child health and reproductive health and HIV prevention. She's also an expert on reproductive health that highlights women's issues with HIV AIDS through the International AIDS Society and she has been working as a mentor. In 2022 she was an emerging voices fellow. Rizka's been a speaker in the virtual international day of the midwife for several years now and she presented her research in both 2021 and 2022 and again this year. So in 2021 she was awarded the Paragon Innovations Award for Southeast Asian Women and the Social Innovation of Health Initiative in Indonesia. And we're very excited to hear about Rizka's latest research which is called Designing Digital Healthcare to Increase HIV Testing among Pregnant Women in Indonesia. So I'll now hand over to Rizka. Okay Terry thank you for the wonderful opening and I will to discuss about our research in Indonesia. The title is Designing Digital Healthcare to Increase HIV Testing among Pregnant Women in Indonesia. So we can move in the problem and solution in our research to increase HIV testing among pregnant women in Indonesia. Data from report of the Ministry of Health of the Republic of Indonesia show that the prevalence of pregnant women experiencing HIV infection was 0.39%. In Indonesia 694 the prevalence of pregnant women experiencing HIV positive. While at the Dr. Sarchito Hospital in Yogyakarta in 2020 there were 30 pregnant women with HIV. This issue should be of significant concern to the public which should be more aware of the dangers of this infection both for the mother and her child. One of the obstacles to handling HIV is late diagnosis due to a lack of access to diagnostic services in health facilities. In addition the negative stigma against this disease also makes people reluctant to diagnose to health facilities. So this is the table of HIV prevalence in different groups in Indonesia. You can look at that in the table. The 2014 Health Reforms in Indonesia at 4K for increased universal health cooperates for all Indonesians including the provision of integrated human immunodeficiency virus programs with HIV testing to be available at community health centers and hospitals for pregnant women and also in Puskas Mas or public health centers and women of childbearing age. Annually in Indonesia 40% of new HIV cases occur in women and childbearing age. So these women fall outside, prescribe high risk groups. For example in commercial sex workers, housewives, injecting drug users and men who have sex with men and female who have sex with female and the steps increased in HIV prevalence among women to children and HIV policies and programs cannot remain ignorant of HIV transmission in women especially among pregnant women. Pregnancy occurs among women living with HIV and as such infants are vulnerable to HIV transmission from their mothers through pregnancy delivery and or breastfeeding and HIV prevalence in 0.4% in pregnant women will indicate that approximately 25,000 out of 6 million pregnant women are HIV positive at any one time in Indonesia. Of concern is that pregnant women often find out their HIV status in the late states of pregnancy resulting in late treatment for preventing mother-to-child transmission or PMPCT without timely and effective HIV treatment during pregnancy half of HIV positive pregnant women will give birth to HIV positive babies. Further without antiretroviral therapy or ARV those infants will likely die before their second birthday. Less than 10% of pregnant women in Indonesia access PMPCT service and misoportunities for early HIV screening and treatment for pregnant women remain a huge challenge so it's interesting to resolve them and this is the program of PMPCT or preventing mother-to-child transmission is implementing HIV testing as a part of PMPCT Indonesia is mandatory for pregnant women and must carry out once during the first antenatal care visit. Unfortunately the HIV testing policy in Indonesia still has loop holes for the mother or the patient to refuse to take the HIV test. HIV testing in pregnant women is only about 13.38% although 98% do pregnancy checks at health facilities. Early diagnosis needs to be done especially in pregnant women as an essential condition that needs to be known is childbirth and breastfeeding. Hard workers are required to offer HIV testing but the mother's voluntary willingness determines the HIV test. Lack of understanding, lack of knowledge and stigma make not all pregnant women willing or afraid to do blood tests in the laboratory. And this is the solution for our research about digital healthcare namely Xtreme. Okay Xtreme innovative strategy for pregnant women in the prevention of HIV-AIDS by utilizing website-based information and communication technology. The Xtreme is website consists of the five primary services namely information, HIV-AIDS, free online counseling, behavioral screening, location search information services for HIV test services, HIV test scheduling and antiretroviral reminders and for people with HIV-AIDS or people living with HIV. This media is an HIV service solution integrated with digital system and making it easier for them to access HIV services. So you can access in www.extreme.org but unfortunately it's about the Indonesian so it is not developed sorry and I can develop in the next year maybe. So this is methods, results and conclusions to make sure the influence of digital healthcare and the implementation trial pilot study use random cluster sampling to select seven intervention and seven control sites in Yogyakarta City Indonesia. Seven intervention health facilities use the Xtreme website for three months from January through April 2022 to educate and do HIV counseling with pregnant women patients and after after randomization process was carried out in the treatment and control group the research assistant conducted a pre-test through questionnaire to find out knowledge about HIV-AIDS susceptibility of HIV, self-efficacy, social norms, perception of HIV risk, response to the risk of HIV transmission and acceptance of digital media extreme. Blending between the subject of the study and the researcher from the allocation process to the analysis is applied to prevent information bias. Peer educators provide access to the URL of the HIV service website to be test and provide socialization to the treatment group on how to access digital media for health literacy, counseling and HIV screening independently and is about independent, not the health workers helping to them and peer educators also assist treatment groups in online counseling before and after the study subjects conducted self-screening using digital media. At the same time the control group was also given a place table in the form of access to the healthcare website URL to see information on HIV test scheduling. Meanwhile education and screening are carried out by peer educators through program that have been implemented in the form of providing early flats as well as considering services and HIV screening directly. The duration of the intervention next week with follow-up by peer educators every week. The study subjects of the treatment and control group will be given an HIV test card that can be asked for a clinic stamp when conducting HIV testing. This card is evidence of whether the study subject has had an HIV test or not so it's very important. After six weeks the research assistant will ask the treatment and control group research subjects to fill out the questionnaire during the pre-test and report whether or not they have done an HIV test by collecting an HIV test card. Our research intervention process is completed, analysis has been carried out and proven efficacy. Researchers will also socialize and provide digital media access to the control group to get the same benefits as the treatment group. So it is the part of the trial about three months but the duration of the intervention only six weeks and all about the intervention is three months. And the results. Extreme website was designed for use on mobile phones to improve HIV testing among pregnant women. Hot workers managed to record 1594 visits and were able to increase HIV testing by 6.7% in pregnant women also. The extreme pilot demonstrated the feasibility of implementing a digital healthcare integrated solution in a low-resort setting. Hot work capacity building and patient self-care into a single-robe use and responsive system. So the extreme pilot demonstrated the feasibility of implementing a digital healthcare integrated solution in a low-resort and especially in Indonesia and in low and middle-income countries. In the last slide, it's conclusion of our study. Although the implementation phase was only three months or about six weeks until three months, the pilot generated evidence that extreme cold increased HIV testing uptake among pregnant women. The cohort studies are needed to estimate the effect of a longer duration. So I think the recommendation of the next study is important because for the evaluation of extreme or about the flow in extreme to scale up innovation in the next step or the next time. Okay. Yeah. Thank you so much. Do we have any questions? Thank you and thank you for coming and for feedback. Thank you, Daddy. Thank you, Riska. So there aren't currently any questions in the public chat. So if you've got any questions for Riska, if you want to pop them there, that would be really helpful. Riska, when do you plan on doing the next round of interviews or of your study? Yeah. I think I will to develop the digital healthcare in the next application, maybe in mobile application, not only in the website. And I add the feature in the anti-retrofero treatment reminder and also not only in pregnant women but also in the other community, maybe in the community in adolescent or in the next community, in other community, not only in pregnant women, maybe, Daddy. Oh, that's exciting. Yeah. So you're going to extend it to, you're sticking with women or are you going to extend it to men as well? Yeah. In this year, I do only in pregnant women and adolescent because it is PhD thesis, my PhD thesis. And in the next research, maybe I will to explore in other community and develop in the next future, maybe, not only in the website. And I open the collaboration with other researchers to exploring and to develop the application so it can move in the next country or the next city with the other language. Excellent. Well done.