BLQ Checkpoint - Sandro Mattioli
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This document discusses BLQ Checkpoint, a peer-based community service that provides rapid HIV testing, STI testing, counseling, and linkage to care. Key services discussed include rapid HIV testing using finger sticks by nurses, peer counseling before and after testing, and possible implementation of HCV and syphilis testing. The document also outlines the need for such services in Italy, where an estimated 150,000 people are living with HIV but about a quarter are undiagnosed. It notes barriers like stigma, lack of harm reduction policies for men who have sex with men, and lack of reliable data on at-risk populations that contribute to the ongoing HIV epidemic in Italy.
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BLQ Checkpoint - Sandro Mattioli
- 1. Sandro Mattioli PLUS Onlus BLQ CheckPoint Barcelona, 05 October 2014
- 2. Sandro Mattioli PLUS Onlus BLQ CheckPoint Barcelona, 05 October 2014
- 3. BLQ checkpoint Services Peer - Community based Rapid HIV test (finger stick – nurses) Peer counselling (before+after) STI (HCV, syphilis) PEP, TASP, PrEP Possible implementation: HCV and syphilis
- 4. blq checkpoint characteristics and methodology People with reactive HIV test: counselling and clinic – Groups – Workshops • People tested negative counselling on safer sex, stigma towards HIV-positive Repeat test every 6-12 months.
- 5. blq checkpoint characteristics and methodology People with reactive HIV test: counselling and clinic – Groups – Workshops • People tested negative counselling on safer sex, stigma towards HIV-positive Repeat test every 6-12 months.
- 6. Plus services what we offer now Positive gay sex Positive Line HIV Task Force
- 7. blq checkpoint opening.... (?) From 2005 to… (2015???)
- 8. Plus Onlus Why 10 years for a Checkpoint In Italy we fight HIV in at least 2 directions, on the social level
- 9. Plus Onlus Why 10 years for a Checkpoint bureaucracy and the inaction of public health COA estimate 150,000 HIV+ in Italy, about a quarter of them don't know they're HIV+; no effective campaign to bring out the underworld; Public campaigns: generalist and inefficient (or harmful) No policy of harm reduction for MSM We have few reliable data on the MSM population, only estimates from incidence; We don't have prevalence studies on most at risk populations; We don't know how many Elisa test are provided in Italy;
- 10. Plus Onlus Stigma and discrimination within the gay community and public health “gay” and “HIV” not in the same sentence; No gay sex in campaigns vs HIV; PEP – PrEP what? (condoms are cheaper than drugs); Difficult to talk about sexual practices; HIV+ shame; (double if gay) Health care personnel discriminates; Better not to know;
- 11. STIGMA SSTTIIGGMMAA if you know me, you avoid me?
- 12. Late presenters among new diagnoses, 2012 Heterosexual MSM IDU Blood Per cent Vert. Transm. Other Use of antiretroviral therapy before AIDS by way of transmission
- 13. NEW DIAGNOSIS ER New diagnoses of HIV infection by mode of transmission and province of residence, Emilia-Romagna, from 2006-2011. (percentages) source: LO STATO DELL’INFEZIONE DA HIV/AIDS IN EMILIA-ROMAGNA Aggiornamento sull’epidemia al 31/12/2011
- 14. Plus Onlus info@plus-onlus.it BLQ Checkpoint Thanks for your attention info@plus-onlus.it
Editor's Notes
- Hi everybodies First of all I have to ask you “sorry” for my English because is really not very good. My name is Sandro Mattioli. I chair Plus that is an LGBT HIV+ association, most of our associated are MSM HIV+, we're based in Bologna, Italy. Bryan asked me to tell you about our Checkpoint and some problems that we had to manage in our city and in our region. And because Bryan told us to stay in the 10 minutes, and this is my first English presentation, I decided to write some notes so that I can read.
- First of all I have to tell that our checkpoint isn't open yet. This is what is planned. As second think I want to tell you that or checkpoint will work keeping in mind 2 central concepts: peer and community based, because they're the true innovations for Italy (so maybe you can imagine the late that we have). I think that our checkpoint will not be much different from the others. We'll provide rapid HIV test (finger stick) with peer counselling before and after each test. and we hope that, thanks to the fact that we're an association, not a hospital, not an ambulatory, will make easier for MSM people to talk frankly about sexual practices, safer sex, risk perception, and stigma, of course, that's play an important role. The test will be anonymous, confidential and for free; it will be done by nurses, kindly offered by the local health authority. We'll also provide information on STI (expecially HCV and syphilis that are very common in the community and, as soon as possibile after the openig, we plan to provide test for this 2 STI. Of course we also give information about these 3 new prevention techniques
- In case of reactive test, the person will receive counseling and an appointment with an infectious disease physician for confirmation of the result. In Italy it is mandatory confirmation by western blot test. We plan to activate support group for HIV+ people, and specific workshops for MSM living with HIV. In case of negative results, we'll provide counselling on risk perception, safer sex and stigma towards HIV-positive people.
- In case of reactive test, the person will receive counseling and an appointment with an infectious disease physician for confirmation of the result. In Italy it is mandatory confirmation by western blot test. We plan to activate support group for HIV+ people, and specific workshops for MSM living with HIV. In case of negative results, we'll provide counselling on risk perception, safer sex and stigma towards HIV-positive people.
- At the moment, the association provides positive gay sex: not for real I'm afraid, it's a booklet, a sexual guide for positive MSM (Giulio's been a very good performer, I'm very happy to punish him, to leave me alone here). and positive line, twice a week (Wednesdays and Sundays from 6 to 10 pm). We also have a group of volunteers who make information on HIV, safer sex, stigma and so on in gay bars, clubs, and so on... so called
- We plan to open the BLQ Checkpoint at the beginning of 2015. Thanks to the fact that, a couple of months ago, we finally signed an agreement with the Municipality and the local health authority that give us the permission to open and manage the first community based Checkpoint of Italy. The point, now, is that we have to renovate our place, that, as you can see, is quite destoyed, at a cost of around € 100,000. In case, we accept checks
- COA estimate 150,000 HIV+ in Italy, about a quarter of them don't know they're HIV+; no effective campaign to bring out the underworld; Public campaigns: generalist and inefficient (when not harmful) / For example in Italy after 30 years of epidemic, this is our idea of effective prevention. After all, we're a country where a pope said that condoms are not the answer to fight HIV. And as a matter of fact, you'll not see condoms, or anything else to reminde us that HIV is an STI: no sex we're catholics. No policy of harm reduction for MSM We have few reliable data on the MSM population, only estimates from incidence; We don't have prevalence studies on most at risk populations; We don't know how many Elisa test are provided in Italy;
- - Many gay organizations and leaders of the LGBT movement don't want to read the words “gay” and “HIV” in the same sentence; - They don't want that gay sex is used for campaigns against HIV; in 2 words: no national policies and programming. This was a national campaign of the biggest gay association, and this was my answer... many gay leaders accused me of pornografy and discrimination for this immage. - The homosexual community is left to the Middle Ages, it is very difficult to talk about PEP or PrEP (because condoms are cheaper than drugs); - It is difficult to talk about sexual practices in Italy except to be a doctor and speak Latin so that no one understands; - Being HIV positive is still a shame; Being gay and HIV-positive is a double shame for both the general population and for the gay community; - Health care personnel (outside clinics of infectious diseases) often discriminates people living with HIV; This is an acceptance document to an emergency room of a public hospital, the guy walked to corridors with this red text - Even today, many gays prefer not to know, at least a quarter of the msm population has never done an hiv test in life;
- In fact, our first work as Plus has been on the stigma. We try just to attack one of the most famous (and worse) ministerial campaigns
- This chart, which always leaves me speechless: refers to people who have made use of ARV therapy before the diagnosis of AIDS. Not HIV, attention to AIDS. Official data of the COA. Look at the light blue bar of the MSM, this is a good answer for those who argue that we are a population that is already alerted and carefully ... all lie
- This is a study of our regional center of control. New diagnoses divided by province and transmission. The yellow bar indicates the new diagnoses among MSM and the green one are the heterosexual males. AS you can see in Bologna we have more new diagnoses among MSM than among Heterosexual males, as a percentage of course. These are the two main data that convinced the authorities to act, even if with an incredible late.