Programming Connection

Targeted Testing Initiative 

Vancouver STOP Project
Vancouver, British Columbia
2013

Introduction

“We can prevent the late diagnosis of HIV/AIDS.”

One of the key markers of success for the Vancouver STOP Project is the expansion of opportunities for HIV testing and early diagnosis for all people in Vancouver. To reach specific populations disproportionately affected by HIV, including gay men, people who use injection drugs, sex workers, refugees, immigrants and Aboriginal people, the Vancouver STOP Project expanded the number of settings that now routinely offer HIV testing to clients – either with standard blood- draw tests or rapid, point-of-care tests. In many of these sites, HIV testing was not previously available or testing rates were low. Access to testing has been expanded in primary healthcare centres, mental health and addictions services, supportive housing, in the justice system and in other settings.

The small Targeted Testing Team identified, collaborated with, trained and supported 88 sites to introduce the routine offer of HIV testing as part of their complement of services. In some settings, such as primary healthcare centres where clinicians were already accustomed to ordering blood work and delivering difficult diagnoses, the change has been relatively smooth. In other venues, such as dental clinics and mental health and addictions services where HIV testing has traditionally not been offered, in part due to significant structural barriers, it’s been more challenging.

Across all sites, ongoing and responsive support has been critical to the success of this project. Nurse educators from the Targeted Testing Team return to sites every few months to offer additional support and to help reduce barriers to embedding testing in health services. Importantly, they also provide updates on each site’s testing trends, which demonstrates to the staff how many tests they have done, the number of new diagnoses and possibly, what impact the initiative is having in Vancouver.

According to Misty Bath, a former nurse educator on the team, the team works hard to ensure that clinicians know there is support for them when one of their patients is diagnosed with HIV. When a person tests positive for HIV, clinicians can draw on the expertise of the STOP Outreach Team or Vancouver Coastal Health Communicable Disease Control to offer specialized diagnosis and linkage to care services.

In addition to supporting others to offer expanded testing opportunities, the Targeted Testing Team hosts HIV testing events at universities, and staffs micro-clinics in bathhouses and a mobile outreach van that travels to outdoor sex venues frequented by gay men and other men who have sex with men.

The team has made significant inroads in normalizing HIV testing both among clinicians and among the people for whom they provide care. According to Bath, “There’s still a lot that we can do to sustain improvements in testing.” As part of this drive, the team is currently working closely with First Nation communities located within Vancouver Coastal Health to increase the availability of testing for Aboriginal people closer to home.