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Transcript
2014 One Year of Community-Based Testing Activities in Milan, Italy Oldrini*, M.L. Cosmaro*, S. Penon*, S. Giudici*, S. Curridori*, M. Giannelli*, M. Angarini*, D. Guarini*, S. Colombo*, D. Savarino*, N. Ceserani**, S. Chiappetta***, M.R. Parisi***, A. Lazzarin***, S. Nozza*** * Fondazione LILA Milano ONLUS ** Azienda Ospedaliera Treviglio *** Ospedale San Raffaele Massimo Oldrini - [email protected] ICAR – Riccione, May 18, 2015 Community based HIV testing activities were possible thanks to three projects: • “DETECT-HIV – Study on experimental interventions and strategies aimed at accompanying people belonging to key affected groups in the Milan metropolitan area to take the test for HIV” • “Definition of operational instruments and contexts and evaluation of the economic impact of the offer of HIV testing outside of consolidated healthcare settings, through the use of rapid tests – Proposal of technical data to policy makers who define operative strategies” • “TESTIN' LILA - CBVCT – The first Milanese site for the offer of HIV and HCV tests, partner of the “Community Based Voluntary Counselling and Testing” (CBVCT) Cobatest network, aimed at the early detection of the infections in people belonging to key affected groups in the metropolitan area” and to the cooperation with other organizations and institutions RESULTS 635 oral rapid tests for HIV were offered in 2014 Number of tests per setting - Total 635 tests Total testing sessions/days: 70 Setting description 25 21 20 15 63; 10% 40; 6% 21 78; 12% 100; 16% 15 11 354; 56% 10 2 5 0 LILA premises MSM venues Clinic for migrants Service for PUD Recreational venues MSM venues Clinic for migrants Service for PUD Recreational venues Screening test results 11 624 Non reactive LILA premises Reactive 635 tests - 622 people Age of clients Setting • LILA premises • MSM venues • Clinic for migrants • Service for PWID • Recreational venues Avg age 30,74 38,78 36,02 40,71 31,22 Range 17 - 67 17 - 83 19 - 61 23 - 63 21 - 52 CBVCT identifier code 13 clients returned to take a 2nd test during the course of the year Gender N=622 5; 1% Nationality N=622 28; 5% 155; 24% 162; 25% 468; 74% Male Female Transgender 452; 71% Foreign Italian No Risp Data collected on clients’ behaviors 599 people reported sexual activity in last 12 mos 151 Women Sexual partners in last 12 mos 443 Men Sexual partners in last 12 mos 134; 30% 16; 11% 280; 63% 9; 6% 126; 83% 29; 7% Omosex Bisex Eterosex Omosex 5 transgenders reported they had sex with other men in last 12 mos Condom use in last sexual intercourse 20; 3% 2; 0% 259; 42% 341; 55% Yes No Don't Know No Risp Bisex Eterosex Data on HIV risk exposure Exposure to sexual risk for etero-bisexual women N=135 24 10 Broken condom Broken condom 48 Unprotected oral sex Unprotected anal sex 91 Unprotected vaginal sex Unprotected vaginal sex 106 Risk exposition 0 20 149 118 Unprotected oral sex 18 Unprotected anal sex Exposure to sexual risk for MSM N=309 40 Yes 60 11 205 Risk exposition 80 100 120 140 160 0 50 No Yes Exposure to risk for PWID (N=20) Sharing of injecting material 20 13 15 10 100 7 5 0 Syringes or needles Spoons filters water 150 No 200 250 300 350 Reactive test results: 11 – Some data: • 2 reactive tests were detected at the drug treatment service (3,17% of 63), 8 at MSM venues (2.25% of 354), 1 at LILA premises (1.28% of 78) • 9 out of 11 clients are men; of them, 8 reported having sex with men only, one with both men and women. • 8 clients are Italian; 3 have a foreign nationality • One of the two women with a reactive result is a PWID 11 Reactive results 7 hospital to confirmation test 7 linkage to care CD4 count N=5 533 (250 -871) in cART 2 Conclusions • 35,27% of total clients had never tested before and explained they had never found the right time or the sufficient motivation to do so • 71% had exposed themselves at the risk of HIV infection • 42% had not used/consistently used condoms/femidoms • Clients appreciated the presence of non-medical staff and peer counselors in outreach settings • 4 clients with reactive tests results were not linked to care, but linkage of the other 7 clients was successful • Rate of reactive results above average in the different settings: 3,17% at drug treatment service; 2.25% at MSM venues; 1.28% at LILA premises • Good cooperation was established with other ONGs. They were trained on community based testing activities and collaborated in the offer of rapid tests Suggestions for improvement • The offer of outreach testing activities to clients of drug treatment services should be increased – 29% of them had never tested before • More support should be given to community based testing activities so that the necessary continuity to services is ensured – both at NGO premises and in outreach settings • Community based testing should be demedicalized, in favor of the adoption of UNAIDS screening criteria proposal • Policy makers should be involved in the promotion of community based testing • Dove possibile partnership tra ONG e centri clinici