ACON HIV testing update
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An update on ACON's a[TEST] initiative in NSW. This presentation was given by Phillip Keen (KIrby Institute) and James Gray (ACON) at the AFAO National HIV Forum, 17 October 2014.
![ACON AND TESTING
THE A[TEST] PARTNERSHIP](https://image.slidesharecdn.com/20140603testingupdate-141023200339-conversion-gate02/85/ACON-HIV-testing-update-1-320.jpg)
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ACON HIV testing update
- 1. ACON AND TESTING THE A[TEST] PARTNERSHIP
- 2. TODAYS PRESENTATION • Current Services • Future Plans • Other Testing Initiatives
- 5. RAPID HIV TESTING IN NSW Identifying undiagnosed men is a key strategy for reducing new infections Declining testing rates necessitated new options Changes in the needs of gay men meant changes for ACON Community mobilisation remains key
- 7. A[TEST] SURRY HILLS • Opened June 2013 • Wednesday and Thursday evenings • Now averaging 16 clients per night • Almost always fully booked • Five cases of HIV detected • Satisfaction - 326 clients rated the a[TEST] service .The service was rated at 4.83 out of 5 for overall satisfaction (96.6%), with 100% of clients saying that they would use the service again and recommend it to others. • Partner Service: Sydney Sexual Health Centre
- 8. A[TEST] NEWTOWN • Opened November 2013 • Open Mondays and Tuesdays • Averaging 7-8 clients per night • Major promotional push to begin in July • Three cases of HIV detected • Partner Service: RPA Sexual Health Clinic
- 9. A[TEST] KINGS X • Began in May 2014 • Soft launch, with promotion increasing • Lots of bookings but more ‘no-shows’ • No cases of HIV detected yet • Partner Service: Clinic 180/Kirketon Rd Centre
- 10. A[TEST] OXFORD ST – POP UP • February to Match 2014 • Nearly 600 clients • 12 cases of HIV detected • Satisfaction - 4.86 out of 5 (97.2%). Almost all clients (99.4%) stated that they would use a[TEST] again, with 99.7% saying that they would recommend the service to others. • Partner Service: Sydney Sexual Health Centre
- 11. A[TEST] OXFORD ST - PERMANENT • Service Partner: Sydney Sexual Health Centre
- 12. OTHER TESTING DIRECTIONS • Regional Services • Western Sydney • Home based testing • Home based sample collection (DBS)
- 13. CHALLENGES • Regulatory barriers • Funding barriers • Staffing barriers
- 14. Nicolas Parkhill Karen Price Timmy Lockwood Vickie Knight Colleagues at Sydney Sexual Health Centre, RPA Sexual Health, Clinic 180/KRC, Kirby Institute, ACON James Gray ACON jgray@acon.org.au, 9206 2041 ACKNOWLEDGEMENTS
Editor's Notes
- Introduce self New service – may have heard some of this before Emphasis partnership
- Until recently, NSW had experienced a decade of relative stability in HIV notifications. In our context, gay men and other men who have sex with men are the most affected population, making up between 70% and 85% of cases annually. In recent years there has been a jump in notifications, particularly amongst gay men which mirrors trends seen in many other comparable jurisdictions. While increases are of course concerning, we believe that there is optimism about our ability to end the epidemic in NSW and testing is going to play a significant role.
- The NSW HIV Strategy 2012-2015: A New Era has the overall goal of the virtual elimination of HIV transmission in NSW by 2020. Eight targets have been set which are integral to achieving the overall goal, one of which is to reduce the transmission of HIV among gay men and other homosexually active men by 60% by 2015. One of the key aspects of achieving this target is a substantial increase in HIV testing, which means that Government and HIV sector agencies are asking gay and other homosexually active men to test far more, despite some within this group of men already testing relatively frequently. Within ACON, our HIV Action Plan also situates increasing testing rates as part of the core business of the organisation, particularly through partnerships with existing clinical services and leveraging off our deep connections with many different community groups.
- With the support of the NSW Government and HIV sector partners, ACON has been reorientating aspects of its services in order to work with clinicians to provide this as a testing option for gay men in community based settings. By this I mean appropriately trained peer workers, in this case gay men, are providing rapid HIV testing to other gay, in non-clinical settings. The peers handle the informed consent, discussion of any risk factors, perform the test and give the result. ACON is certainly not the only community organisation performing this work in Australia, with or sisters organisations here in Melbourne, the Victorian AIDS Council, and in Perth, the Western Australian AIDS Council also providing similar innovative services. The changing context of the epidemic in NSW required an analysis of long term health promotion projects and their ongoing utility. Some programs had to be changed or reduced in order to accommodate the new focus on our community-based HIV testing services. The introduction of rapid HIV testing has fundamentally changed the HIV testing experience for gay men, which is producing results – with more men testing, including men who haven’t tested before. Reorientating a large organisation in response to new targets can be disruptive and challenging, however the rewards can also be clearly demonstrated. In this case the experience of a[TEST] has shown that new service options and the use of new technology can be effective in attracting first time testers and those that have not tested regularly. Earlier this year there was a jump of 5% in the number of men reporting having been tested and the decline in those saying they had ever been tested has stopped in the last two years. While we are always wary of putting too much into changes year on year, these are nevertheless good signs.
- Community mobilisation is the key to achieving the changes in safe behaviour, testing and treatment required to end HIV by 2020. This requires the ongoing support of organisations that are part of the communities that they serve. Understanding the barriers that some men face, such as privacy, stigma, cost and time, and developing ways to overcome them requires a deep understanding of the sexual culture of gay men and a willingness to engage with that culture in an open, direct and positive way, which can be difficult for government agencies to do.