Borrowing from our neighbours: Developing an annual HIV testing day

Over the last three years, the AIDS Committee of Windsor (ACW) has held an annual HIV Testing Day in the Windsor-Essex and Chatham-Kent regions of Ontario. The idea was ignited by National HIV Testing Day in the United States, which occurs annually on June 27^th. Each year ACW’s testing campaign consists of a testing day, followed by ongoing promotion of HIV testing throughout the year. Testing takes place at the ACW office every first and last Wednesday of the month, and in various clinics in the region.

National HIV Testing Day in the United States increases the number of tests and new HIV-positive test results

National HIV Testing Day is used in the United States to promote and increase HIV testing. The event takes place annually and hundreds of local events take place. Most local events offer HIV testing and are accompanied by media and social marketing campaigns that improve knowledge about HIV prevention, testing and care services; address barriers to getting tested; and encourage HIV testing.

A study¹ on the effect that National HIV Testing Day (NHTD) has on HIV testing in the United States showed very positive results. During the period of the study, there was an increase in both the number of tests performed and number of new HIV-positive test results during the week of NHTD compared to two control weeks. The study also showed significant increases in the percentage of HIV tests in high-risk populations, including gay men and other men who have sex with men (MSM) and non-Hispanic Black people.

HIV Testing Day at AIDS Committee of Windsor

Despite the success of the American campaign, Canada does not have a specified national testing day. In response, ACW decided to parallel the American initiative to increase awareness of HIV and HIV testing in their community. The first testing day occurred on June 27, 2013. Kicking off the annual HIV testing campaign in the last week of June aligns its efforts with the American testing campaign when the American NHTD occurs. This timing takes advantage of the summer weather when more community members are actively engaging in outdoor activities making them more inclined to attend a testing event.

The campaign targets the 21% of people who are living with HIV in Canada who do not know their HIV-positive status. People who are aware they have HIV can access the benefits of care and treatment^2,3 and reduce the risk of transmission to others.^4,5,6

Over the last three years, ACW’s campaign has focused on recruiting community partners that serve its priority populations, including women; African, Caribbean and Black communities (ACB); and MSM. These include the Windsor Regional Hospital HIV Care Program, Windsor Essex Community Health Centres, Chatham-Kent Community Health Centres, and Stephen Jones Medicine Professional; the Windsor-Essex County and Chatham-Kent Public Health Units; and community groups including, Sandwich Teen Action Group, Place Concorde, Access County Community Support Services and Community University Partnership.

ACW took some key steps in developing its testing campaign:

• Consulted with its closest American AIDS service organization, AIDS Partnership Michigan (APM). ACW gained valuable insight regarding APM’s campaign strategy, successes, and how an annual testing event helps to normalize HIV. APM emphasized that ongoing promotion throughout the year was key to the success of the event and this ongoing promotion assisted with publicizing anonymous testing at their agency. These strategies were incorporated into ACW’s campaign.
• Identified areas in Windsor-Essex and Chatham-Kent where priority populations live and focused campaign promotion efforts in those areas.
• Established testing sites by partnering with organizations whose services cater to ACW’s priority populations. ACW facilitated educational presentations to staff at these organizations so they would encourage service users to participate in testing events.
• Worked with a graphic design company to develop promotional materials for the campaign.
• Ensured that the HIV testing cards were available in other languages (Swahili, Somali, French and Arabic).

In 2015, the annual campaign kickoff occurred on June 24 and 25 in Windsor-Essex and June 26 in Chatham-Kent. The 2015 region-wide HIV Testing Day resulted in 41 people getting tested for HIV over the three-day span. This represented a 356% increase in participants from 2014 (n=9) and 2013 (n=9). To date, there have been no HIV-positive tests during ACW’s HIV Testing Day events. ACW believes 2015’s success was the result of increased partnerships, ongoing promotion and increased campaign recognition in the community.

How can you host an HIV Testing Day event in your region?

ACW has held an HIV Testing Day event since 2013. Their tips for hosting a successful HIV testing event include:

• Advertise testing via radio, newspaper, and billboards
• Use  free advertising through university campus media groups, community message boards, and ethno-racial magazines
• Use social media to promote the testing days and locations (online dating applications, Facebook, YouTube, etc.)
• Begin promotion at least three months before the testing day
• Incorporate only minor revisions to the marketing materials to ensure marketing continuity from year to year
• Offer an HIV 101 presentation prior to the testing date for service providers at participating testing locations
• Recruit volunteers to assist with ongoing organizing efforts and with raising community awareness about the testing campaign
• Where possible, offer other sexually transmitted infection testing at participating sites
• Engage the larger community through community partners and service providers using HIV 101 presentations, lunch and learns, and brief information sessions about testing

What do the ACW and American experiences tell us about the potential of a National HIV Testing Day in Canada?

A study of NHTD in the United States showed increased overall testing numbers and newly identified HIV-positive test results compared to two control weeks. Although ACW has not compared its testing numbers during its HIV Testing Day event compared to other days in the year, ACW has shown that the campaign has attracted an increased number of people to test since the first event in 2013.

Both NHTD and ACW’s event expand access of testing sites to non-healthcare settings. This may be an important way to attract people to HIV testing.

A national HIV testing day in Canada modelled on some of the lessons from the American campaign and the experience from Windsor-Essex and Chatham-Kent in Canada could potentially increase the number of people who test for HIV and know their status.  

References

1. Van Handel MM, Mulatu MS. Effectiveness of the U.S. National HIV Testing Day Campaigns in Promoting HIV Testing: Evidence from CDC-funded HIV Testing Sites, 2010. Public Health Reports. 2014 Oct;129:446–54.
2. The INSIGHT START Study Group. Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection. New England Journal of Medicine. 2015 Jul 20;150720091517005.
3. Samji H, Cescon A, Hogg RS, Modur SP, et al. Closing the Gap: Increases in Life Expectancy among Treated HIV-Positive Individuals in the United States and Canada. Okulicz JF, editor. PLoS ONE. 2013 Dec 18;8(12):e81355.
4. Cohen MS. Antiretroviral Treatment Prevents HIV Transmission: Final Results from the HPTN 052 Randomized Controlled Trial. In: Program and abstracts of the 8th Conference on HIV Pathogenesis, Treatment and Prevention, 19–22 July 2015. Abstract MOAC0101LB.Available at: https://www.youtube.com/watch?v=Ro7svS9Deu0&feature=youtu.be
5. Rodger A. HIV Transmission Risk Through Condomless Sex If HIV+ Partner on Suppressive ART: Partner STUDY. Oral presentation at: 21st Conference on Retroviruses and Opportunistic Infections, Boston, USA, 2014. Available at: http://www.croiwebcasts.org/console/player/22072
6. Grulich AE, Bavinton B., Jin F. HIV Transmission in male serodiscordant couples in Australia, Thailand and Brazil. Late breaker poster 1019 LB presented at: 22nd Conference on Retroviruses and Opportunistic Infections, Seattle; USA, 2015.

About the author(s)

Racquel Bremmer is the African, Caribbean, and Black Community Outreach Coordinator at the AIDS Committee of Windsor. She has been working in the HIV/AIDS field for over 20 years and has been involved with capacity building, education and health promotion initiatives in Toronto, Jamaica and Norway with international non-profit organizations like the Red Cross as well as government-funded agencies across Ontario. She has a passion for social justice and anti-oppression and hopes to increase access to HIV testing in marginalized communities all over Canada.

The ACW HIV Testing campaign is an annual Education and Outreach Department initiative. Its success is credited to the Department’s Director, Pauline Nash and the previous strategy workers – Colm Holms, Stephanie Green and Lydia Chan (ex-staff) and its current team, Samantha Pockele, Christopher Cartier, Kimberly Levergood and Racquel Bremmer.