3. Promoting HIV Testing in Diverse Populations
Working With Community Organizations
At the same time as healthcare practices are developing their own staff resources and competence for conducting routine HIV testing, involvement of individuals and organizations in the communities that they serve should also be cultivated.
Community-based organizations typically are already working with some of the highest-risk populations who also may not be accessing medical care. These may
include individuals who have not yet felt a need to seek out healthcare:
- Asymptomatic HIV-infected persons
- Injection drug users
- Younger individuals
Community-based organizations, especially those in communities of color, often have closer ties to people who are most vulnerable to HIV acquisition and can connect with people at social venues, through friendship networks, or sexual partner networks. These are the types of connections and programs that clinics and hospitals may not be accustomed to working with, or even know of them.
Identifying organizations that are already conducting HIV testing or are willing to consider doing so represents a key initial step, followed by discussing with them the services that the healthcare practice can offer. Community-based organizations tend to have relationships in which open communication with clients is valued, and this can help facilitate developing relationships between the organization and its clients and the healthcare practice.
Once a healthcare facility has established its own procedures for routine HIV testing and cultivated relationships with community organizations and individuals, consideration can be given to concrete programs and services that will encourage larger numbers of individuals to participate in screening.
Because socioeconomic status can be one driver of the HIV epidemic itself and of community members’ inability or reluctance to seek testing and care, offering material incentives may be one way to get past such barriers. These could include:
- Transportation (bus, train, taxi) vouchers
- Food stuffs or coupons
- Meal services
- Mobile phones
- Telephone calling cards
- Gift cards
Such incentives may be especially useful if they are offered to those who bring another patient along for testing. However, practitioners should realize that enacting such incentives can be challenging on several levels, including operational, technical, and even ethical, and such concerns should be thoroughly addressed before moving forward.
Other community outreach efforts can be more educational and promotional in nature:
- Develop programs that encourage racial/ethnic community members to learn more about HIV and to discuss its impact among family, friends, and other connections
- Promote HIV counseling and testing options
- Collaborate with local community-based organizations to promote HIV prevention and testing services
- Utilize social marketing campaigns—eg, Facebook, Twitter, public service announcements on local radio stations
- Promote extended hours of care
- Provide routine rapid HIV testing in settings such as:
- Emergency departments and urgent care clinics
- Sexually transmitted disease clinics
- Obstetric/gynecology clinics
- College and university clinics
- Prison clinics
- Mobile healthcare vans—ie, street testing
