1. CLINICS AND COMMUNITY
Dr Mags Portman

2. Where does prevention sit in a clinical context?
Day to day working
Routine HIV testing in clinical setting
Motivational Interviewing and Behavioural Intervention
Safer sex and Harm reduction
Part of clinic strategy
Finding those most at risk and tailoring services to them
Educating other clinicians
Promoting rapid & repeat test offer (AWARE RCT)
Host organisation
Promoting staff know their HIV status at health events etc
Roadshows/screensavers to promote HIV testing in patients
Local health pathway ‘how to test’ pathways & materials
Part of local Sexual Health and HIV strategy
National HIV Testing Week
Evaluating new technologies eg. Self-testing kits; dried blood spots

3. How, when & where can we implement routine HIV testing?
Traditional settings (GUM, antenatal, TOP)
Other hospital settings (Hepatology, Oncology, Colposcopy, TB clinics, general medical admissions, A&E)
“Pop Up” clinics at events for MaRPs
Supporting GPs in high prevalence areas to offer testing
Within 3rd sector organisations
Outreach – “working together” clinic & community ie) saunas, churches, street-based mobile health units
Working with Public Health to understand areas of greatest need
Sexual Health websites (postal kits)

4. How can we bring clinicians and community together to support each other in our common aims? Our Story
Leeds Centre for Sexual Health
Hosted coordination meetings, ideas, volunteers, training sessions
Leeds Contraception and Sexual Health (CaSH)
volunteers, hosted sessions
Leeds City Council
support, promotion
Yorkshire MESMAC
outreach (incl online), engaged local clubs and bars, provided sessions
BHA Skyline
engaged new African community venues, provided sessions, volunteers, outreach in City Centre
Dec 2012 Y&H data
Leeds becomes only high HIV prevalence area in Y&H
?2.14/1000

5. Leeds NHTW Results
All sessions took place in community venues; African community/gay bars and clubs
Collected more data - wanted to know if we were accessing people not testing via traditional sexual health clinics
Word of mouth/outreach or the presence of testers in a venue proved the most effective way of recruiting. 31% of MSM learnt of testing via the internet
Tested over 70 people per day at GUM clinic

6. Leeds NHTW 2013 - Results 126 people tested 90 (71%) from MARPS
( tested, 51% MARPs)
61(48%) MSM, with 5 reporting sex with men and women
27 (21%) Black African (16 male)
There were no HIV positive results
>95% of people tested were given advice on PEP, repeat testing, STI screening and offered condoms

7. Leeds NHTW 2013 - Results MSM Black Africans
40% had never tested for HIV
63% had never tested, or tested >12/12 ago
68% did not know about PEP
54% had never attended GUM
Of those who recalled being seen in GUM, none had been seen in the preceding year
Black Africans
15% had never tested for HIV
63% had never tested or >12/12 ago
81% did not know about PEP
64% had never attended GUM

8. Leeds NHTW Media
Talk about the H&Wbeing board/DPH event at time when SH service out to tender & real threat of SH-HIV service fragmentation etc

9. Leeds NHTW 2013 – Learning Points
Start organising earlier – NHTW is for life, not just a week in Nov!
More advertising and media involvement earlier
Collect data regarding venues and numbers attending to focus efforts next year
Those with experience of outreach achieved higher testing numbers
NHTW provides a platform for ongoing testing
Much closer relationships between clinic and community organisations