1. On behalf of GNP+ and PLHIV partner organisations
Co-funded by the 2nd Health Programme of the European Union
The OptTEST Project
Overview of outputs of stigma and legal and regulatory barriers work
Julian Hows
On behalf of GNP+ and PLHIV partner organisations

2. Legal and regulatory barriers website
Co-funded by the 2nd Health Programme of the European Union
Tools and work done
Legal and regulatory barriers website
Demonstration projects in Belarus, Estonia, Poland, Portugal, Germany, Greece, Ukraine
Tips sheets and case studies
Literature review

3. Legal and Regulatory Barriers Website /Tools
What is it? …
The site covers 53 countries of the WHO Europe region
Thanks to all those who contributed – the data is up and live and has gone through several refinements
The site is being updated on an iterative basis

4. How the data is searchable…
Each of the countries can be clicked on to show some top line information
And clicked on to show the full data set for that country

5. Snapshot for a country …
Czech Republic…
There are links link to show all of the data sources used for each of the categories of information …

6. Uses and Impact …
The website has engaged with 600 plus respondents across the WHO region
at ALL LEVELS OF THE RESPONSE
It receives between 100 and 200 ‘hits’ a month
It is being quoted and utilised by community groups and others in advocacy and policy work

7. Demonstration projects activities/outcomes
Co-funded by the 2nd Health Programme of the European Union
Demonstration projects activities/outcomes
Belarus - increased access to sexual and reproductive health services for women PLHIV
Estonia - ‘empowered patient’ programme put in place in two cities
Greece – identification of structural barriers impacting on PLHIV access to services via stigma index implementation
Poland – increased ‘disclosure’ by PLHIV- increased testing outreach services
Portugal – increased sensitivity and possibilities for testing at primary care level
Germany - testing campaign for young MSM
Ukraine – changes to care continuum and service delivery guidance

8. Co-funded by the 2nd Health Programme of the European Union
Conclusions
Each of the country community partner networks has been enabled and had resources to
Identify a specific issue (or issues) impacting on the testing and treatment continuum
Carry out a project activity – from a community development (PLHIV) perspective
Assist and ensure that individual , as well as categories of PLHIV, are better ‘served’ and services more appropriate are in place

9. Findings….
A picture has emerged of restrictive practices and regulations including:
Lack of access to, and use of, proven new testing technologies and settings
‘Questiónable’ restrictions on who can administer tests
Unnecessary requirement for extensive pre/post test counselling
Refusal to accept referrals from community testing into care
Limited testing sites and restricted types of test
Wider barriers to improving the continuum of care included: separation of healthcare into vertical specialities (e.g. drugs care separate from HIV and from TB); lack of case management systems; failure to integrate healthcare and social support; disruption of care between civil and detention authorities.
Complex entitlement regulations and charging systems deterring/excluding migrants, including even those entitled to healthcare sometimes. 

10. Next Steps… http://legalbarriers.peoplewithhiveurope.org/index.php
OptTest as a project ends in September we hope the database will continue by
Being updated on a iterative basis as new information comes in
Being better aligned and cross refrenced with other regional and global data sets that GNP+ is the custodian of such as
PLHIV related stigma -
The criminalisation of HIV non-disclure, expoisure and transmission and other punitive laws that impact on the HIV response
To better drive and support data driven advocacy from a PLHIV and community perspective

11. Tip sheets
Simple principles for effective campaigning on legislative or regulatory change
What types of legal and regulatory barriers are common and how do they damage access?
What are the new testing strategies and where are they working?
How can I identify and verify local barriers to testing and treatment access?
How can I construct or compare a continuum of care?  
How can we do a simple, quick, low cost but robust survey of an issue?
How and where do I find evidence for a change in policy?
How can we build alliances between community, clinicians and public health?
How should we present our case to decision-makers and politicians?
Influencing at conferences and other events
Questions you should ask yourself (and be able to answer) before you ask to meet with a Government Minister
What can we do when politicians ignore the evidence?