Public Health AIDS Services has provided HIV testing since 1991. From 1991 to 1997, testing was conducted at a stationary site at the Boston Medical Center using standard counseling protocols and serum samples. In an effort to reach drug injectors at high risk for infection, the program was restructured to include oral mucosal testing on the agency's needle exchange van. Program strengths include: 1) accessibility of service; 2) trust of service based on client use of needle exchange; 3) high level of client knowledge about HIV transmission; 4) ongoing contact between counselors and test clients; 5) access to support services for infected clients; and 6) access to risk management counseling for uninfected clients. Outreach testing also challenges traditional testing paradigms, and counselors identified areas of concern: 1) Needle exchange clients have less time to invest in testing; 2) Confidentiality can be compromised in outreach settings; 3) Drug-using clients minimize sexual risk; 4) Women access needle exchange less than men; 5) Return rates are low; 6) Infected clients need intensive support services to manage their mental and physical health. Program staff have developed an outreach testing protocol that optimizes program strengths, addresses potential problems in service delivery, and employs an expanded support services model focused on medical advocacy.
Learning Objectives: At the conclusion of the presentation, participants will be able to: 1) describe traditional and non-traditional HIV testing paradigms; 2) articulate the strengths and challenges related to outreach HIV testing; and 3) identify the components of an outreach testing protocol
Keywords: HIV Interventions, Needle Exchange
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Boston Public Health Commission (AIDS Services)
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am the Director of AIDS Services at the Boston Public Health Commission.