HIV Testing in the Community:HIV Testing in the Community:Responding to the Glasgow Outbreak
Dr Lee MiddletonGlasgow Alcohol and Drug Recovery ServiceGlasgow Alcohol and Drug Recovery Service
Background
• ORT clinics in GovanORT clinics in Govan• Average caseload of 150‐200Q l di l i• Quarterly medical reviews
• BBV testing offered at routine reviews
Background
60HIV cases in PWID
40
50
30
40
10
20
02006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Problem
• Frequently decline testingFrequently decline testing• 15% tested for HIV in preceding 12 monthsH i ?• How to increase awareness?
• How to increase testing numbers?
Methods
Awareness campaignAwareness campaign• Briefing to multidisciplinary staff team
i i li i• Poster campaign in clinic • Start open conversations around HIV and testing
Methods
Dry blood spot testingDry blood spot testing• Testing period identified
d h b ff i• Targeted approach by staff to promote testing• Identified medic available throughout to facilitate• Instant access to testing for all accepting
Results
• 148 patients identified attending Govan ORT clinics• All 148 offered HIV test
• 146 (98.6%) accepted tests • Marked impact on figures across South Glasgow
HIV tests
Acceptedp
Declined
Discussion
• Unexpectedly high uptake rateUnexpectedly high uptake rate• Change in approach led to significant increaseLik l l if i l• Likely multifactorial
Could it be repeated?Could it be repeated?
Year 2
60
HIV cases in PWID
50
60
30
40
10
20
0
10
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Year 2 Results
• 172 patients identified attending Govan ORT clinics during172 patients identified attending Govan ORT clinics during target 4 week period
• All 172 offered HIV tests at clinic appointment• All 172 offered HIV tests at clinic appointment• 172 (100%) accepted• Increase in acceptance rate of 1.4%• Of original 2015 cohort, 86 (59%) still attending and accepted g , ( ) g prepeat testing
Year 2 Discussion
Increased awarenessIncreased awareness
IntegratedIntegratedNo stigmaNo stigma Integrated team
Integrated team
I dI dNo waitNo wait ConsistentConsistentIncreased HIV testsIncreased HIV tests
No‐wait tests
No‐wait tests
Consistent staff
Consistent staff
Conclusion
• Simple but highly effectiveSimple, but highly effective• Easy to replicateC ld b li d diff h l h i i i i• Could be applied to different health promotion activities