CLINICS AND COMMUNITY Dr Mags Portman. Day to day working Routine HIV testing in clinical setting Motivational Interviewing and Behavioural Intervention.

CLINICS AND COMMUNITYDr Mags Portman

Day to day working• Routine HIV testing in clinical setting• Motivational Interviewing and Behavioural Intervention• Safer sex and Harm reduction

Part of clinic strategy• Finding those most at risk and tailoring services to them • Educating other clinicians• Promoting rapid & repeat test offer (AWARE RCT)

Host organisation• Promoting staff know their HIV status at health events etc• Roadshows/screensavers to promote HIV testing in patients• Local health pathway ‘how to test’ pathways & materials

Part of local Sexual Health and HIV strategy• National HIV Testing Week• Evaluating new technologies eg. Self-testing kits; dried blood spots

Where does prevention sit in a clinical context?

Traditional settings (GUM, antenatal, TOP)

Other hospital settings (Hepatology, Oncology, Colposcopy, TB clinics, general medical admissions, A&E)

“Pop Up” clinics at events for MaRPs

Supporting GPs in high prevalence areas to offer testing

Within 3rd sector organisations

Outreach – “working together” clinic & community ie) saunas, churches, street-based mobile health units

Working with Public Health to understand areas of greatest need

How, when & where can we implement routine HIV testing?

How can we bring clinicians and community together to support each other in our common aims? Our StoryLeeds Centre for Sexual Health

– Hosted coordination meetings, ideas, volunteers, training sessions

Leeds Contraception and Sexual Health (CaSH)

– volunteers, hosted sessionsLeeds City Council

– support, promotionYorkshire MESMAC

– outreach (incl online), engaged local clubs and bars, provided sessions

BHA Skyline – engaged new African community venues,

provided sessions, volunteers, outreach in City Centre

Leeds NHTW 2013 - Results• All sessions took place in

community venues; African community/gay bars and clubs

• Collected more data - wanted to know if we were accessing people not testing via traditional sexual health clinics

• Word of mouth/outreach or the presence of testers in a venue proved the most effective way of recruiting. 31% of MSM learnt of testing via the internet

Leeds NHTW 2013 - Results

• 126 people tested • 90 (71%) from MARPS• (2012 - 94 tested, 51% MARPs)• 61(48%) MSM, with 5 reporting

sex with men and women• 27 (21%) Black African (16 male)

• There were no HIV positive results • >95% of people tested were given

advice on PEP, repeat testing, STI screening and offered condoms

Leeds NHTW 2013 - Results

• MSM – 40% had never tested for HIV– 63% had never tested, or

tested >12/12 ago– 68% did not know about PEP– 54% had never attended GUM– Of those who recalled being

seen in GUM, none had been seen in the preceding year

• Black Africans – 15% had never tested for HIV– 63% had never tested or

>12/12 ago– 81% did not know about PEP– 64% had never attended GUM

Leeds NHTW 2013 - Media

Leeds NHTW 2013 – Learning Points

• Start organising earlier – NHTW is for life, not just a week in Nov!

• More advertising and media involvement earlier

• Collect data regarding venues and numbers attending to focus efforts next year

• Those with experience of outreach achieved higher testing numbers

• NHTW provides a platform for ongoing testing

• Much closer relationships between clinic and community organisations