Increasing HIV outreach and testing in high-risk groups: Crossing the socio-cultural borders of a hidden men who have sex with men community

Seventy-three percent of AIDS cases reported in Riverside County, CA are men who have sex with men (MSM). Riverside County is unique in that the Eastern region includes a highly visible gay resort destination where HIV education and prevention activities targeting MSMs are established and accepted. In the more conservative Western region, including the city of Riverside, however, the MSM community is widely dispersed with few acknowledged gathering places. Riverside County Department of Public Health (DOPH) HIV/AIDS outreach staff was challenged to provide educational and testing to this largely underground community. Staff collaborated with an artist well known in the gay and bisexual community to use his artwork to advertise outreach and testing services. One original art piece was purchased and the use of four others was donated by the artist. The artwork was used to create culturally and linguistically appropriate posters with slogans in both English and Spanish to encourage testing. Contact information for the DOPH HIV/AIDS program was included on the posters. Wallet cards with sites and schedules for rapid testing were created. Cards and posters were distributed at known gay and gay-friendly businesses in the Riverside area. Staff also attended meetings at the burgeoning LGBT community center to establish contacts and get information on additional locations to distribute posters and wallet cards. The use of these culturally relevant materials was successful. Since the inception of the project there has been a 200% increase in testing by gay and bisexual men. Future directions include expansion of internet-based outreach.