HIV Testing Seminar

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Testing Barriers Project: 

Testing Barriers Project Gay Men’s Health

Background: 

Background The Testing barriers Project works exclusively with gay and bisexual men. Gay and bisexual men represent the group with the highest prevalence of HIV infection in Scotland. The overwhelming majority of new cases of HIV acquired in Scotland in 2004 were among men who have sex with men. There remains a clear need for targetted health promotion work with gay and bisexual men.

Brief History of the Project: 

Brief History of the Project Research by Dr. Paul Flowers, 2000 Only 55% of gay men in Edinburgh had had an HIV test Fear of a positive result associated with beliefs about what it means to be HIV positive was the most common reason given for not testing Perceived high incidence of HIV stigma and discrimination informed gay men’s beliefs about what it was like to be HIV positive

Main Interventions: 

Main Interventions Involving gay and bisexual men with HIV Peer Education Bar Staff training Health promotion events Information resources Research

Research Findings: 

Research Findings The level of HIV testing had increased from 62% in 2003 to 73% in 2004 There is an increasing number of men who have had unprotected anal intercourse with people of unknown status who have not had a test The importance of HIV testing for the group of gay men who are HIV+ but do not know they are positive was highlighted These men perceive many barriers to HIV testing, the most common of which remains fear of a positive result associated with beliefs about what it means to be positive

Research Findings: 

Research Findings In contrast to the 2003 study and the original “Testing Barriers” research, there was very little difference in perceived stigma and discrimination between those who had tested and those who had not. Although HIV stigma appears to be becoming more of an acceptable risk when deciding whether to have an HIV test, HIV positive status is still widely thought to bring with it stigma with associated mental and physical health problems and sexual problems.

Conclusions: 

Conclusions Stigma related to being HIV+ continues to be prevalent on the gay scene and in wider society and needs to be continually challenged Any materials or health promotion initiatives involving HIV testing should seek to facilitate informed decision making although achieving an increase in HIV testing is a legitimate long term aim For the majority of people who have engaged in HIV risk related behaviour, the benefits of having an HIV test will outweigh any possible disadvantages

Conclusions: 

Conclusions Health promotion agencies have a responsibility to ensure people are aware of these benefits and are not unnecessarily discouraged from having a test. Clinics and health professionals need to ensure that access to testing is straightforward and that the choice of how and where people can have an HIV test is as wide as possible. The important role of gay men with HIV in tackling stigma and discrimination should be acknowledged and encouraged. Work should clearly highlight each individual’s own responsibility to ensure sexual safety occurs.

Conclusions: 

Conclusions There are still many barriers to HIV testing which need to be addressed. These include: clinic opening times, the role of GP’s in offering HIV tests, the appropriateness of compulsory pre-test counselling, the current position regarding criminalisation of HIV transmission, the role of community based testing and home testing.

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