REVIEW OF THE FIRST TESTING WEEK FOR MSM IN ILE DE FRANCE

• Half of new HIV infections affect MSM• The incidence is estimated at 3.8% among men frequenting gay venues in Paris• Transmission of HIV is important during primary infection• Young MSM are less informed and less concerned than their elders (echoes from the field)• Gay-oriented rapid testing programs are still rare in France.

CONTEXT

• Promote and encourage annual screening for HIV and other STIs among MSM, as often as necessary for certain subgroups

• Reduce the time between infection and screening

• Reach out to MSM furthest from screening

MAIN OBJECTIVES

• Train medical staff working in testing centers (CDAG) to perform rapid tests and counselling adapted to MSM

• Mobilize prevention and LGBT organizations

•Make visible existing screening operations

• Encourage certain GPs to offer rapid tests

SECONDARY OBJECTIVES

CALENDAR OF ACTION

• 03/26 to 04/08: Communication Campaign diffused in LGBT organizations, commercial places and on LGBT media and Internet Sites

• 04/02 to 04/08: the public was offered an HIV test with an immediate result in about 40 places

COMMUNICATION

•Flashy and sexy style• No explicit reference to HIV• A catchy slogan: "And you, you know? "• Using the flash code for mobile phone connected to a dedicated Website• Several media: posters, internet banners, flyers folded form of calendar, t-shirts, stickers

DEVICE

• 39 testing sites- A mobile unit in the gay district (le Marais)

- Health and screening centers, 1 sexual health center, emergency service (7)

- Gay commercial venues (saunas, sexclubs, 1 bar) (8)

- Organizations sites (11)- Outdoor cruising areas (13)- Private physicians' offices (16)

STAKEHOLDERS

• 15 trained health workers collaborated with about 70 prevention workers

• About 70 activists from AIDES Association, trained in testing and counselling

• 15 GPs trained in the use of INSTI tests

RESULTS

• 556 tests performed• 9 people have discovered their HIV+ status•A questionnaire self-filled by 98.9% of users (539)• 369 MSM have filled out the questionnaire•7 MSM have discovered their HIV+ status ; a prevalence of 1.90% in this group

RESULTSATTENDANCE

Total MSM Total MSM

7 132 40 30% 267 0,5 0,2 04 71 25 35% 49 1,5 0,5 0

1 155 123 79% 51 3,0 2,4 28 58 53 91% 30 2,0 1,8 211 132 105 80% 66 2,0 1,6 21 87 82 94% 29 3,0 2,8 0

10 45 23 51% 37 1,2 0,6 2

13 71 39 55% 79 0,9 0,5 216 10 9 90% - - - 1

% MSMNb

HIV+ dicovered

Outdoor cruising areasPrivate physicians' offices

Excluding 190, Check Point, Emergency

Attendance by site Nb Tests Nb tests / hourNb hours of action

Medical Centers

Mobile Unit (Marais)Gays commercial venuesLGBT and Prevention organizations

Centre LGBT IDF

Prevention organizations

ATTENDANCE in short

• Sites located in the gay district were the most attractive for MSM : 3.5 tests/h between 5 and 10pm (4 HIV+)• Medical centers were not attractive• Outdoors cruising areas needed more time of action and MSM are difficult to target (79h; 0.6 test/h; 2 HIV+)• Communication about the operation had a positive impact on attendance at existing organization’s sites (37h; 1.2 tests/h; 2 HIV+)•GPs were not proactive but efficient when they were (1 positive test out of 9 proposed by 1 GP)

AThe 369 MSM were aged 17 to 76 years old. They live mostly in

Paris (51%) or in the Paris region (31%).

Under 25 16%

25 to 29 19%

30 to 34 18%

35 to 44 24%

Over 45 23%

Age of MSM

A26 % report 11 partners or more during the last 12 months

No partner1%

1 partner6%

2 to 10 partners49%

11 to 49 partnairs26%

Over 50 part10%

NA8%

Number of sexual partners (last 12 month)

A34 % report at least one UAI in the last 12 months

Yes, once20%

Yes, several times14%No

63%

Not concerned3%

NA0%

UAI (last 12 months)

NNNNNNgggggggghhhhhh

42% of men had not made any HIV test in prior 12 months

Less than 6 months

33%

6 to 12 months25%

1 to 2 years19%

More than 2 years15%

Never tested8% NA

0%

Date of last HIV test

FREQUENTATION DES SITES Nombre de Lieux

Nombre de tests réalisés

% cible

Nombre de decouvertes de séropositivités

Total Cible HSH

Lieux médicalisés 7 132 40 30% 0

Lieux médicalisés (Hors 190, Check Point, Urgences) 4 71 25 35% 0Unité Mobile Marais 1 155 123 79% 2Etablissement gays 8 58 53 91% 2Locaux associatifs 11 132 105 80% 2

Centre LGBT IDF 1 87 82 94% 0Permanence santé AIDES 10 45 23 51% 2

Lieux de rencontre exterieurs 13 71 23 32% 2Cabinets médicaux 16 10 9 90% 1

•Significantly, the use of screening increases with the number of partners• But 50 % of men aged 45 and older report having had at least 11 partners and haven’t been tested for HIV over the last 12 months•Half of men aged under 25 reports having had at least one UAI in the past 12 months (vs. a third in the other age groups) but they get tested more often than others•Within the limits of this sample, men who have never been tested were more likely to report sex with women in the last 12 months

Partners, UAI, testing and age

A

• 3 men, aged over 30, had not performed tests for more than 2 years and declared they did not consider conducting a screening.•3 men, aged under 30 , had been tested in the last 12 months and 1 (between 30 and 34 years) within the last 2 years. They report having made at least 3 tests within that period.

Similar trends in the use of screening for all respondents of the sample

MSM respondents who discovered their HIV+ status

CONCLUSION

• Flash Test could attract MSM who had not been tested for at least 1 year (42%) • It succeeded in reducing the time between infection and screening for youngest• and succeeded in reaching out to MSM furthest from screening

An annual Testing Week for HIV should be organized, extended to other areas and other priority groups

ACKNOWLEDGEMENT

Financial partners: MAC AIDS Fund, Inpes.Institutional partners: Afssaps; DGS; Inpes; Invs; Ville de Paris.Organizations: Act Up; AIDES; Association des Médecins Gays; Le Centre LGBT Ile-de-France; le Crips IDF; HF Prévention; Le Kiosque Info Sida et Toxicomanie; Checkpoint; RainbHôpital; Sida Info Service; le SNEG Prévention; Les Sœurs de la Perpétuelle Indulgence; Solidarité Sida; le Mag.Media: Agence Blue Savanah; CitéGay.com; Tetu.com; Yagg.com; Prends-moi magazine; Agenda Q; Wank.Medical structures: Hôpital Bichat ; Hôpital Saint Antoine ; Hôpital Pitié Salpêtrière ; Hôpital Ambroise Paré ; Hôpital Fernand Vidal ; Centre Médico-social du Figuier ; Centre médico-social Maire-Volta.Gay commercial places: l'Atlantide Sauna; les Bains d'Odessa; le Bunker; le Dépôt; le Gym Louvre; le Riad; le Sun City; le Til’t Sauna; le Quetzal.Laboratory: NéphroteK (Insti TM)

MORE ACKNOWLEDGEMENTS

Steering Committee: Antonio Alexandre (SNEG) ; Pr. Anne-Claude Crémieux (CHU Garches), Dr Philippe Dhotte (CDAG Figuier), Vincent Douris (Sidaction) ; Sandrine Fournier (Sidaction) ; Stephen Karon (Sidaction) ; Veronica Noseda (Sidaction).

Evaluation group: Constance Delaugerre (Hôpital Saint-Louis), Jean-Yves Le Talec (Université Toulouse-Le Miral, Annie Velter (INvS)

Communication group: Hervé Baudoin (SIS association), Lucile Bluzat (Inpes), Dominick Descharles (Aides), Christophe Martet (Yagg)

On line testing experience group: Frédérique Delatour (DGS), Philippe Dhotte (CDAG Le Figuier),Tim Greacen (EPS Maison Blanche), Eric Laforgerie (Afssaps), Arame Mbodje (SIS), François Simon, (Hôpital Saint Louis), Cécile Vaugelade (Afssaps), Thierry Saint Marc (Association des médecins gays), Anne-Claude Crémieux (CHU Garches)

Thank you!