How community-based agencies used policy changes and mass media campaigning to promote HIV testing to MSM in England and Wales
A. Wardle1, P. Ward2
1Terrence Higgins Trust, Health Promotion, London, United Kingdom, 2Terrence Higgins Trust, London, United Kingdom
Issues: UK community-based organisations were traditionally cautious about promoting HIV testing. Research showed, being mostly hospital-based, that testing also presented barriers to MSM. Both factors resulted in lower testing rates than comparable countries. In order to normalise testing and reduce undiagnosed infection THT, leading the CHAPS partnership of community organisations (funded by the Department of Health), sought to identify and reduce obstacles to testing.
Description: THT adopted recommendations that all MSM test at least annually. From November 2008 it delivered with its partners three national mass media campaigns encouraging repeat testing. The focus was on levels of undiagnosed infection, health benefits and ease of testing (highlighting rapid tests), and improving perceptions of hospital-based clinics. A web site addressed common obstacles around testing and clinics (eg, fear and inconvenience), helping men locate community-based and clinical testing services (www.thinkhiv.co.uk).
Lessons learned: Caution around testing among community organisations is disappearing but persists among MSM. Research showed men have an outdated understanding of HIV infection, what happens in clinics and minimise risks of being undiagnosed. Focus groups, especially of young men, did not endorse fear-based approaches to the promotion of testing (they had high impact but failed to motivate men to test). Statistical data on increased life expectancy was not personally motivating but linking testing with taking control was. Awareness of rapid testing was low and men wanted more promotion of it. Only by addressing barriers to accessing HIV tests can testing be effectively promoted.
Next steps: In its work to reduce undiagnosed infection THT is adopting pro-testing recommendations for other groups and will encourage similar organisations to follow. Community-based rapid HIV testing will be expanded among MSM and other groups. The testing website and other campaign elements for MSM offer a model for future work around reducing undiagnosed HIV with other groups such as UK-based Africans.
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