Testing in Europe 

What's hindering and what's helping? 

 

Lisa Power 

 

EATG/AVAC January 2016 

What's wrong with testing now? 

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Testing programmes are underfunded 

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Many testing campaigns aren't targeted 

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Stigma makes people reluctant to test 

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Laws and regulations act as barriers too often 

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New testing strategies often blocked by vested 

interests and “custom & practice” 

Legal barriers 

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Criminalisation of exposure/transmission 

- testing 
- disclosure of risk when seeking help 

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Criminalisation of some key pops (varies) 

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Legal barriers for migrants/trans people (most) 

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Mandatory testing drives people underground 

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Lack of protective legislation e.g. in work  

Regulatory barriers 

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What kind of tests can be done 

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Where testing can take place 

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Who can do tests or give results 

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Activities reserved to specific professions 

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Outdated guidelines 

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Financial barriers for NGOs 

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Barriers to referrals after testing for NGOs 

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Anonymity that isn't (demanding ID for tests) 

Creative responses 

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Hiring your own doctors/nurses/pharmacists 

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Sticking only to the letter of the law/regulation 

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Ignoring the law (sometimes w/govt. collusion) 

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Getting national guidance updated 

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Document/publicise what isn't working 

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Collaboration with clinicians, public health 

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Projects creating change – e.g. OptTEST 

Creative responses 1: OptTEST 

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Ten partners, funded by EU and matching funds 

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Timescale 2014-2017, four key areas 

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Linkage to care  

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Guided testing for indicator conditions 

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Cost effectiveness of some testing strategies 

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Stigma, legal & regulatory barriers 

Can you help us in this? 

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Country database 

 

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Examples of current legal/regulatory barriers 

 

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Case studies of overcoming such barriers 

 

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Toolkit – what would help you make change? 

Creative responses 2: Testing Week 

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European HIV (now + HCV) Testing Week 

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Now in 4

th

 year; 417 active participants in 2015 

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Evidence & toolkit online at testingweek.eu 

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Half report resource barriers but only one in ten 

use it as a lever for influencing 

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You can use it any way you want (and 

influencing can be cheap) 

Creative responses 3: using tech 

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Euro HIV Test Finder 

-   find a test anywhere in the EU 
-   works with key sex apps/mobile friendly 
-   40k visits, 75k page views in Testing Week 

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Increasing interaction with sex app owners 

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Use of apps as triage for postal/home testing 

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Reduced cost, increased targeting 

What more can we do? 

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Challenge vested interests in restricting testing 

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Work with pub. health, clinicians who agree 

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Focus on key pops especially MSM, migrants 

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Participate in European testing initiatives 

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Document the case for change locally 

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Shout about how we can increase testing 

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Be more creative and less afraid of change