1. Testing for key populations – from the perspectives of those living with HIV Ed Ngoksin Global Network of People Living with HIV (GNP+)

2. Concerns of members of key populations living with HIV

3. Individual-level barriers to HIV testing Intersecting stigma (or layered stigma) Fear over how others would treat them should the result come back positive Healthcare worker discrimination Criminalisation Violence enacted by intimate partners, other family and/or community members

4. Individual-level barriers to HIV testing (cont.) Fear of not being able to cope with a positive HIV test result No perceived benefits of finding out if they are HIV-positive IDUs give precedence to drug use and not health/HIV Lack of supportive social and peer norms for HIV testing Denial of risk and low HIV risk perception Waiting time between blood testing and result of the test

5. Health care system barriers to HIV testing Health provider attitude and discrimination Location of HIV testing centers Restricted services hours in government hospitals Waiting time for counseling/test and getting test result No counseling is made available at all

6. Policy, program, legal barriers to HIV testing Criminal laws against key populations and non-disclosure Lack of effective coordination and linkages among various services (such as drug dependence treatment) and HIV testing Lack of funding for community-based HIV testing Government IEC/mass media campaigns only target general populations Policy restrictions (e.g. parental consent, policy restrictions on who can perform rapid testing) And many more…

7. Reasons for HIV testing

8. Reasons for HIV test (%) Monitoring access to treatment in Asia – Selected findings community Access to treatment, care and support study, APN+, July 2014)

9. Some community-based services to promote HTC uptake

13. Some considerations Acknowledge the diversities within “key populations” groups Invest longer term on capacity strengthening in service delivery and advocacy of key populations-led initiatives, organisations, networks so that they are able exercise their rights and advocate for systemic/structural changes Invest in locally driven initiatives as they are applying evidence to practice, esp. those that promote and increase demand for HIV testing and link people into care and care retention Better use of social media is needed to connect with key populations and young key populations Sustain support for innovation remain essential Ensure all kinds of testing conform to ethical standards, including confidentiality, consent and safeguard the human rights of key populations against all forms of coercive testing. Put an end to mandatory HIV testing Advocate for communities as equal partners in delivery of HIV testing services at national level

14. Thank you