4 mc grath_innovations in hiv self-testing delivery

2. Commercial Sex Venues
• Commercial sex venue (CSV) in Los
Angeles County (LA County)
• High-risk population that ‘cruise’ for
anonymous sex
• LA County requires CSVs to provide HIV
testing and education

3. Barriers to Testing
• CSV culture
• Client demographics vary
• Busy hours at night versus tester
availability

4. HIV Home Test Kit

5. Vending Machines
• Self-contained unit
• Remote monitoring
• Instructions posted

6. Initial Concerns
• Cost of HIV home test kits
• Emptying the vending machine
• Conflict with existing testers
• Home test kit window period
• Result anxiety
• Gateway to more comprehensive
testing

7. Results
• Scatterplots by week
• Tester schedule (orange blocks):
– Tuesday 9am-5pm
– Thursday 9am-5pm
– Sunday 12pm-4pm

8. Results (12/1-12/7)
12:00 AM
3:00 AM
6:00 AM
9:00 AM
12:00 PM
3:00 PM
6:00 PM
9:00 PM
12:00 AM
11/30/14 12/1/14 12/2/14 12/3/14 12/4/14 12/5/14 12/6/14 12/7/14 12/8/14

9. Results (12/15-12/21)
12:00 AM
3:00 AM
6:00 AM
9:00 AM
12:00 PM
3:00 PM
6:00 PM
9:00 PM
12:00 AM
12/14/14 12/15/14 12/16/14 12/17/14 12/18/14 12/19/14 12/20/14 12/21/14 12/22/14

10. Results (12/22-12/28)
12:00 AM
3:00 AM
6:00 AM
9:00 AM
12:00 PM
3:00 PM
6:00 PM
9:00 PM
12:00 AM
12/21/14 12/22/14 12/23/14 12/24/14 12/25/14 12/26/14 12/27/14 12/28/14 12/29/14

11. Results (12/29-1/4)
12:00 AM
3:00 AM
6:00 AM
9:00 AM
12:00 PM
3:00 PM
6:00 PM
9:00 PM
12:00 AM
12/28/14 12/29/14 12/30/14 12/31/14 1/1/15 1/2/15 1/3/15 1/4/15 1/5/15

12. Results (1/5-1/11)
12:00 AM
3:00 AM
6:00 AM
9:00 AM
12:00 PM
3:00 PM
6:00 PM
9:00 PM
12:00 AM
1/4/15 1/5/15 1/6/15 1/7/15 1/8/15 1/9/15 1/10/15 1/11/15 1/12/15

13. Results (1/12-1/18)
12:00 AM
3:00 AM
6:00 AM
9:00 AM
12:00 PM
3:00 PM
6:00 PM
9:00 PM
12:00 AM
1/11/15 1/12/15 1/13/15 1/14/15 1/15/15 1/16/15 1/17/15 1/18/15 1/19/15

14. Results (1/19-1/25)
12:00 AM
3:00 AM
6:00 AM
9:00 AM
12:00 PM
3:00 PM
6:00 PM
9:00 PM
12:00 AM
1/18/15 1/19/15 1/20/15 1/21/15 1/22/15 1/23/15 1/24/15 1/25/15 1/26/15

15. Results (1/26-1/31)
12:00 AM
3:00 AM
6:00 AM
9:00 AM
12:00 PM
3:00 PM
6:00 PM
9:00 PM
12:00 AM
1/25/15 1/26/15 1/27/15 1/28/15 1/29/15 1/30/15 1/31/15 2/1/15

16. Results Summary
• Vending machine
– 1,176 hours
– 312 tests
• Traditional testers
– 64 hours
– 58 tests

17. Results Comments
• Vending machine
– Available 24/7
– High volume
– No training
– Results unknown
• Traditional testers
– Limited hours
– Low volume
– Requires training
– Results

18. Conclusions
• Unique population in an
‘underground’ venue requires a
specialized intervention
• HIV testing and social acceptance
• Acute infections
• Other concerns

19. Special Thanks
• Lauren Natoli, BA (AHF)
• Adam Carl Cohen, MPH (AHF)
• Laura Anderson, MPH (UCLA)
• Emily Huang (UCLA)
• Jeffery Klausner MD, MPH (UCLA)
• The UCLA Global Health Program