1. Home sampling kits A partnership project run by The Lesbian & Gay Foundation and RU Clear, supported by the MAC AIDS Fund and the Manchester Centre for Sexual Health. James Derham Sexual Health Co-ordinator, The Lesbian & Gay Foundation

2. Barriers to accessing HIV testing: Lack of time, mobility or access issues, lack of appointments, inconvenient times, confidence/confidentiality worries. The home sampling kits bring HIV testing into men’s homes and remove barriers. Background

3. Aim: To increase testing and prevention of the spread of HIV amongst men who have sex with men (MSM) by increasing the number of MSM who know their HIV status. This programme is making a key contribution to the Public Health Outcomes Indicator Framework, to reducing the levels of late HIV diagnoses. Background

4. November 2013 – present. Funded to provide 1200 home sampling kits returned to the lab. Gay or bisexual men aged 16 or over, living in Greater Manchester. Promoted via a range of communication channels. Grindr adverts, netreach, social media, posters. Ordered online or picked up in person from The Lesbian & Gay Foundation. Sample posted off and results received within 1-2 weeks. Methods

6. Innovative reminder service built into the scheme. If kit not returned within – 2 weeks – text reminder sent 4 weeks – phone call made Methods

7. Men with a reactive result receive a phone call and are fast-tracked to a GU clinic of their choice for an appointment with a specialist HIV consultant or nurse. Re-tested to confirm positive result Care pathways – close relationship of partnership enables excellent care pathways. Methods

8. Headline data, November ‘13 – January ‘15: 1586 kits ordered 1101 kits returned 69.4% return rate Results – Interim data

9. Headline data, November ‘13 – January ‘15: 1586 kits ordered 1101 kits returned 69.4% return rate 13 positive results Retention into care: 92.3% (12 people). 33.6% of respondents had never had a previous HIV test. Results – Interim data

10. 78.9% of returned kits, returned within 2 weeks. Return rate prior to reminder: 70.2%. After reminder: 74.4% For those who accepted reminder, return rate: 81.6% For those who didn’t accept reminder, return rate: 68.9% Peak return rate of 87.5% after reminder option introduced. Peak request days correlate with Grindr ads – 55 requests in one day. Results – Interim data

11. Top 10 sites referring to lgf.org.uk/hometesting: 1) LGF website 2) Google 3) Twitter 4) fitlads.net 5) LGF weekly e-bulletin 6) Facebook 7) gaydar.co.uk 8) LGF sexual health text reminder service (outreach clinics) 9) bing.com 10) Manchester Centre for Sexual Health website Importance of promotion on a local level and service user trust in community organisations. Results

12. Age range 16 – 67 Mode age: 23 Risks factors (July ‘14 onwards): 56% had had sex with someone born outside of this country 3.8% had injected drugs, and 9.4% had had sex with someone who had injected drugs 17.4% had had sex with someone they knew was HIV positive 10.7% had paid for or been paid for sex 33.6% had never previously tested for HIV Results

13. The scheme has proved to be very successful so far. Service user feedback has highlighted how easy and convenient the service is to use. Some service users stated they would never access HIV testing via ‘traditional’ means. The kits are helping men who have never tested before access testing services. Results - feedback

14. Results – feedback Came across the service online…..Taking a test is something I've put off for a while and probably still wouldn’t have taken one if I did not do it via the internet

15. Great service - very speedy - should make more people aware of this fantastic approach to sexual health testing Excellent service for people who work full time and unable to attend clinics easily The HIV test kit arrived very quickly. And I appreciate the confidentiality. This is the best thing for shy older gay guys. I think its great. I have been putting off going so this is brilliant easy and less stressful. Came across the service online…..Taking a test is something I've put off for a while and probably still wouldn’t have taken one if I did not do it via the internet I had unprotected sex with a man three years ago. Thanks to a tweet by lgf… I REALISED I MAY STILL BE AT RISK. Thank you for providing this service! I really appreciate the support Very useful for people working >70 hrs p/week Very innovative service & allows privacy during the test procedure

16. Return rate: 69.4% Retention into care: 92.3% Introduction of reminder service increased: - overall return rate by 4.2% - return rate in those who opted for it by 12.7% compared to those who didn’t. Qualitative feedback. Conclusion – key successes

17. Importance of partnership work: Combination of local expertise – triage, systems, care pathways, data analysis, promotion via netreach, HIV Consultant and nurses, providing clinical governance Project can easily be expanded to other regions or to a national level - built off the back of successful Chlamydia programme run by RUClear. Conclusion

18. Men have choice: If men want to test at GUM clinic, we signpost Some men want to test in community settings – LGF provide this (in partnership with Manchester Centre for Sexual Health) in our building and at a local sauna Other men want to test in the privacy of their own homes 33.6% of men have never tested before – if they’d not accessed the home sampling kits, how many would have had an HIV test via an alternative service? Conclusion

19. Thank you The Home Sampling kits project is a collaboration between: RU Clear Manchester Centre for Sexual Health Lesbian & Gay Foundation and has been made possible by: MAC AIDS Fund. Thank you to colleagues from these organisations.

20. Thank you James Derham Sexual Health Co-ordinator The Lesbian & Gay Foundation Number 5, Richmond Street, Manchester. M1 3HF. 08453 30 30 30 james.derham@lgf.org.uk