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Salud y medicina

Commercial Sex Venues
•  Commercial sex venue (CSV) in Los
Angeles County (LA County)
•  High-risk population that ‘cruise’ for
anonymous sex
•  LA County requires CSVs to provide HIV
testing and education

Barriers to Testing
•  CSV culture
•  Client demographics vary
•  Busy hours at night versus tester
availability

Vending Machines
•  Self-contained unit
•  Remote monitoring
•  Instructions posted

Initial Concerns
•  Cost of HIV home test kits
•  Emptying the vending machine
•  Conflict with existing testers
•  Home test kit window period
•  Result anxiety
•  Gateway to more comprehensive
testing

Results
•  Scatterplots by week
•  Tester schedule (orange blocks):
– Tuesday 9am-5pm
– Thursday 9am-5pm
– Sunday 12pm-4pm

Results (12/1-12/7)
12:00 AM
3:00 AM
6:00 AM
9:00 AM
12:00 PM
3:00 PM
6:00 PM
9:00 PM
12:00 AM
11/30/14 12/1/14 12/2/14 12/3/14 12/4/14 12/5/14 12/6/14 12/7/14 12/8/14

Results (12/15-12/21)
12:00 AM
3:00 AM
6:00 AM
9:00 AM
12:00 PM
3:00 PM
6:00 PM
9:00 PM
12:00 AM
12/14/14 12/15/14 12/16/14 12/17/14 12/18/14 12/19/14 12/20/14 12/21/14 12/22/14

Results (12/22-12/28)
12:00 AM
3:00 AM
6:00 AM
9:00 AM
12:00 PM
3:00 PM
6:00 PM
9:00 PM
12:00 AM
12/21/14 12/22/14 12/23/14 12/24/14 12/25/14 12/26/14 12/27/14 12/28/14 12/29/14

Results (12/29-1/4)
12:00 AM
3:00 AM
6:00 AM
9:00 AM
12:00 PM
3:00 PM
6:00 PM
9:00 PM
12:00 AM
12/28/14 12/29/14 12/30/14 12/31/14 1/1/15 1/2/15 1/3/15 1/4/15 1/5/15

Results (1/5-1/11)
12:00 AM
3:00 AM
6:00 AM
9:00 AM
12:00 PM
3:00 PM
6:00 PM
9:00 PM
12:00 AM
1/4/15 1/5/15 1/6/15 1/7/15 1/8/15 1/9/15 1/10/15 1/11/15 1/12/15

Results (1/12-1/18)
12:00 AM
3:00 AM
6:00 AM
9:00 AM
12:00 PM
3:00 PM
6:00 PM
9:00 PM
12:00 AM
1/11/15 1/12/15 1/13/15 1/14/15 1/15/15 1/16/15 1/17/15 1/18/15 1/19/15

Results (1/19-1/25)
12:00 AM
3:00 AM
6:00 AM
9:00 AM
12:00 PM
3:00 PM
6:00 PM
9:00 PM
12:00 AM
1/18/15 1/19/15 1/20/15 1/21/15 1/22/15 1/23/15 1/24/15 1/25/15 1/26/15

Results (1/26-1/31)
12:00 AM
3:00 AM
6:00 AM
9:00 AM
12:00 PM
3:00 PM
6:00 PM
9:00 PM
12:00 AM
1/25/15 1/26/15 1/27/15 1/28/15 1/29/15 1/30/15 1/31/15 2/1/15

Results Summary
•  Vending machine
– 1,176 hours
– 312 tests
•  Traditional testers
– 64 hours
– 58 tests

Results Comments
•  Vending machine
– Available 24/7
– High volume
– No training
– Results unknown
•  Traditional testers
– Limited hours
– Low volume
– Requires training
– Results

Conclusions
•  Unique population in an
‘underground’ venue requires a
specialized intervention
•  HIV testing and social acceptance
•  Acute infections
•  Other concerns

Special Thanks
•  Lauren Natoli, BA (AHF)
•  Adam Carl Cohen, MPH (AHF)
•  Laura Anderson, MPH (UCLA)
•  Emily Huang (UCLA)
•  Jeffery Klausner MD, MPH (UCLA)
•  The UCLA Global Health Program

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4 mc grath_innovations in hiv self-testing delivery

2. Commercial Sex Venues •  Commercial sex venue (CSV) in Los Angeles County (LA County) •  High-risk population that ‘cruise’ for anonymous sex •  LA County requires CSVs to provide HIV testing and education

3. Barriers to Testing •  CSV culture •  Client demographics vary •  Busy hours at night versus tester availability

4. HIV Home Test Kit

5. Vending Machines •  Self-contained unit •  Remote monitoring •  Instructions posted

6. Initial Concerns •  Cost of HIV home test kits •  Emptying the vending machine •  Conflict with existing testers •  Home test kit window period •  Result anxiety •  Gateway to more comprehensive testing

7. Results •  Scatterplots by week •  Tester schedule (orange blocks): – Tuesday 9am-5pm – Thursday 9am-5pm – Sunday 12pm-4pm

8. Results (12/1-12/7) 12:00 AM 3:00 AM 6:00 AM 9:00 AM 12:00 PM 3:00 PM 6:00 PM 9:00 PM 12:00 AM 11/30/14 12/1/14 12/2/14 12/3/14 12/4/14 12/5/14 12/6/14 12/7/14 12/8/14

9. Results (12/15-12/21) 12:00 AM 3:00 AM 6:00 AM 9:00 AM 12:00 PM 3:00 PM 6:00 PM 9:00 PM 12:00 AM 12/14/14 12/15/14 12/16/14 12/17/14 12/18/14 12/19/14 12/20/14 12/21/14 12/22/14

10. Results (12/22-12/28) 12:00 AM 3:00 AM 6:00 AM 9:00 AM 12:00 PM 3:00 PM 6:00 PM 9:00 PM 12:00 AM 12/21/14 12/22/14 12/23/14 12/24/14 12/25/14 12/26/14 12/27/14 12/28/14 12/29/14

11. Results (12/29-1/4) 12:00 AM 3:00 AM 6:00 AM 9:00 AM 12:00 PM 3:00 PM 6:00 PM 9:00 PM 12:00 AM 12/28/14 12/29/14 12/30/14 12/31/14 1/1/15 1/2/15 1/3/15 1/4/15 1/5/15

12. Results (1/5-1/11) 12:00 AM 3:00 AM 6:00 AM 9:00 AM 12:00 PM 3:00 PM 6:00 PM 9:00 PM 12:00 AM 1/4/15 1/5/15 1/6/15 1/7/15 1/8/15 1/9/15 1/10/15 1/11/15 1/12/15

13. Results (1/12-1/18) 12:00 AM 3:00 AM 6:00 AM 9:00 AM 12:00 PM 3:00 PM 6:00 PM 9:00 PM 12:00 AM 1/11/15 1/12/15 1/13/15 1/14/15 1/15/15 1/16/15 1/17/15 1/18/15 1/19/15

14. Results (1/19-1/25) 12:00 AM 3:00 AM 6:00 AM 9:00 AM 12:00 PM 3:00 PM 6:00 PM 9:00 PM 12:00 AM 1/18/15 1/19/15 1/20/15 1/21/15 1/22/15 1/23/15 1/24/15 1/25/15 1/26/15

15. Results (1/26-1/31) 12:00 AM 3:00 AM 6:00 AM 9:00 AM 12:00 PM 3:00 PM 6:00 PM 9:00 PM 12:00 AM 1/25/15 1/26/15 1/27/15 1/28/15 1/29/15 1/30/15 1/31/15 2/1/15

16. Results Summary •  Vending machine – 1,176 hours – 312 tests •  Traditional testers – 64 hours – 58 tests

17. Results Comments •  Vending machine – Available 24/7 – High volume – No training – Results unknown •  Traditional testers – Limited hours – Low volume – Requires training – Results

18. Conclusions •  Unique population in an ‘underground’ venue requires a specialized intervention •  HIV testing and social acceptance •  Acute infections •  Other concerns

19. Special Thanks •  Lauren Natoli, BA (AHF) •  Adam Carl Cohen, MPH (AHF) •  Laura Anderson, MPH (UCLA) •  Emily Huang (UCLA) •  Jeffery Klausner MD, MPH (UCLA) •  The UCLA Global Health Program

4 mc grath_innovations in hiv self-testing delivery

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4 mc grath_innovations in hiv self-testing delivery