CheckpointLX - Marie Jose Campos
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This document describes a community-based anonymous counseling, testing and linkage center for men who have sex with men (MSM) in Portugal called CheckpointLX. It provides free, anonymous and confidential HIV, Syphilis, and HCV rapid tests. The number of HIV rapid tests administered has increased each year from 2011 to 2014. Most tests are for MSM, with a positivity rate of around 5%. The majority of those with reactive tests are referred to treatment protocols. The center also participates in research studies and international networking initiatives. It aims to improve testing practices and referrals through community outreach. The document outlines several current and planned projects, including partner notification, acute HIV detection, and PrEP acceptability research
CheckpointLX - Marie Jose Campos
- 1. Community-based, Anonymous Counseling Testing & Linkage Center for MSM
- 3. CHECKPOINTLX • peer-to-peer led community-based anonymous counseling, testing and linkage center for MSM; • free, anonymous and confidential HIV, Syphilis* and HCV* rapid tests; • GAT (Portuguese HIV/AIDS treatment activists' group) main projects. *Tests established by the STI testing project- Checklist- and provided only when specific criteria are met.
- 4. NUMBER OF HIV RAPID TEST TENDENCY 63 100 83 93 94 116120 111 100 150 138138 114 122 107 154 137 200 180 166 158 250 236 150 134 209 187 155 205 193 167 218217212 244 224219 267 215 262 228 241 221 266 244 300 283 0 50 Apr/11 May/11 Jun/11 Jul/11 Aug/11 Sep/11 Oct/11 Nov/11 Dec/11 Jan/12 Feb/12 Mar/12 Apr/12 May/12 Jun/12 Jul/12 Aug/12 Sep/12 Oct/12 Nov/12 Dec/12 Jan/13 Feb/13 Mar/13 Apr/13 May/13 Jun/13 Jul/13 Aug/13 Sep/13 Oct/13 Nov/13 Dec/13 Jan/14 Feb/14 Mar/14 Apr/14 May/14 Jun/14 Jul/14 Aug/14 Sep/14 Oct/14 2011 2012 2013 2014
- 5. HIV RAPID TEST PER SEXUAL ORIENTATION (APR/2011-APR/2014) 4468 72.80% 988 16.10% 681 11.10% HSH HSH/M OUTROS n=6137
- 6. MSM AND MSM/W HIV RAPID TEST RESULTS (APR/2011-APR/2014) 233 4.53% 4916 95.47% Reativo Não reativo n=5149
- 7. HIV REACTIVE REFERRALS (APR/2011 - APR/2014) 1 0.43% 48 20.60% 184 78.97% Fora do protocolo Recusa Protocolo n=233
- 8. PARTICIPATION ON STUDIES AND INTERNATIONAL NETWORKING 2013/2014 LISBON MSM COHORT Joint GAT/ Oporto Public Health Institute initiative aimed at mapping out HIV infection prevalence, monitoring primary and secondary prevention behaviors, namely condom usage, testing and PEP knowledge (post exposure prophylaxis); COBATEST and EDAT projects Improving testing best practices, community counseling and referrals; SIALON II Sexual behavior study and bio sampling with the objective to determine HIV prevalence among MSM in 12 european cities.
- 9. COMMUNITY PARTICIPATION CheckpointLX services are promoted by a MSM volunteer team in socializing places - online social networks, bars, clubs, restaurants, saunas, cruising areas and specific NGOs. VOLUNTEERS: João Beltrão, João Mariano, José Calisto, José Carlos Ferreira, Letícia Gonçalves, Leo Muñoz, Mário Afonso, Nuno Rodrigues Pereira, Paulo Pranto, Paulo Verdial, Pedro Faro, Stefen Osório, Stijn Coppieters e Vasco Araújo.
- 10. CHECKLIST PROJECT MSM health professional team granting STI clinic (complete screening includes Gonorrhea, Chlamydia, Syphilis and anal HPV cytology and virology). Inclusion of rapid syphilis and VHC screenings to peer-to-peer led HIV screenings at CheckpointLX. Between May 2012 and April 2014, 3520 Syphilis and 258 VHC tests were made and 527 medical appointments.
- 11. PROJECTS 2014/2015 ACUTE HIV INFECTION DETECTION AND REFERRAL FOR EARLY TREATMENT - a partnership between GAT/CheckpointLX and Santa Maria Hospital/Imunosupression Service is being discussed. MSM with acute HIV infection at CheckpointLX (detected trough 4th generation test and/or acute HIV infection signs and symptoms report), will be referred (express link) for medical evaluation and early treatment at Santa Maria Hospital. PRE-EXPOSURE PROPHYLAXIS ACCEPTABILITY AND PREDICTED USE BEHAVIOURS STUDY – ongoing study. MSM INDEX - LED ANONYMOUS PARTNER NOTIFICATION - an app for anonymous partner notification at official CheckpointLX website.
- 12. SEMANTICS: CONTACT TRACING VERSUS PARTNER NOTIFICATION CONTACT TRACING • Formal notification • Professional-led • Specific look-back intervals • Directive/clinical notifications PARTNER NOTIFICATION • Case-index led • Standard look-back intervals • Personalized notifications
- 13. Partner notification definitions WHO CDC ECDC “the process of contacting the sexual partners of an individual with a STI including HIV, and advising them that they have been exposed to infection. By this means, people who are at high risk of STI/HIV are contacted and encouraged to attend for counselling, testing and other prevention and treatment services” (WHO, Questions and answers on reporting, partner notification and disclosure of HIV serostatus and/or AIDS, public health and human rights implications, 1999, p.17” “a process through which infected persons are interviewed to elicit information about their partners, who can then be confidentially notified of their possible exposure or potential risk” (CDC, Recommendations for Partner Services Programs for HIV Infection, Syphilis, Gonorrhea, and Chlamydial Infection, 2008; p.4) “the process whereby the sexual partner(s) of an index patient or case (a patient diagnosed with a STI who presents for care) are identified and informed of their exposure and invited to attend for testing, counselling and, where necessary, treatment” (WHO, Questions and answers on reporting, partner notification and disclosure of HIV serostatus and/or AIDS, public health and human rights implications, 1999, p.17”
- 14. Partner notification methods WHO CDC ECDC Partner notification can be done by the patient, by the health provider or through combined efforts of both (patient referral, provider referral and conditional referral). Partners may be notified of exposure via provider referral, third-party referral, self-referral, contract referral, or dual referral. There is no consistent pattern between countries / laws about partner notification (compulsory notification) and those that had strategies or plans. Patient referral is the preferred method for partner notification for all STI.
- 15. Partner notification outcomes (CDC, Recommendations for Partner Services Programs for HIV Infection, Syphilis, Gonorrhea, and Chlamydial Infection, 2008; p.4)
- 16. Partner notification at CBACT • Voluntary • Safe disclosure environment • Sustainable and less time consuming • Client-centered • Accessible to all • Integrated and comprehensive • Anonymity choice for index case • Index case personal data confidentiality assurance
- 17. Checkout – Index-MSM anonymous partner notification online service 1. Aleatory self generated temporary code given to index-MSM to enter an App or official website 2. QR code leads directly to Checkout 3. Index-MSM is informed: i. how to notify face-to-face; ii. about implications of online partner notifications; iii. to notify within the look-back interval of the STI notified; iv. that notification implies some data registry (IP user); 4. Index-MSM chooses which STI he wants to notify; 5. Index-MSM inserts phone numbers and/or emails of partners; 6. Checkout do the rest; 7. Checkout evaluates its activity and outcome results.