Kuala Lumpur, Malaysia, 30 June - 3 July 2013 Expanding access to non-medicalized community-based rapid testing to men who have sex with men: an urgent HIV prevention intervention (The ANRS-DRAG Study) Nicolas LORENTE 1,2,3, M. PREAU 1,3,4, C. VERNAY-VAISSE 5, M. MORA 1,2,3, J. BLANCHE 1,2,3, J. OTIS 6, A. PASSERON 7, J.-M. LE GALL 8, P. DHOTTE 9, M.P. CARRIERI 1,2,3, M. SUZAN-MONTI 1,2,3, B. SPIRE 1,2,3,8 for the ANRS-DRAG Study Group. 1 INSERM UMR912 (SESSTIM), Marseille, France; 2 Aix Marseille Université, UMR_S912, IRD, Marseille, France; 3 ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France; 4 GREPS, Université Lyon 2, Lyon, France; 5 Conseil Général des Bouches du Rhône, Marseille, France; 6 UQÀM, Chaire de recherche du Canada en éducation à la santé, Montréal, Québec; 7 Conseil Général des Alpes Maritimes, Nice, France; 8 Aides, Pantin, France; 9 CMS-CIDAG-CIDDIST du Figuier, Paris, France, MOPDC0106

Kuala Lumpur, Malaysia, 30 June - 3 July 2013 Objective: To evaluate a community-based, non-medicalized HIV testing offer (CBOffer) in parallel with the standard medicalized HIV testing offer (SMOffer) among MSM in French voluntary counselling and testing (VCT) centres The ANRS-DRAG study: Cross-sectional study in French VCT centres (4 sites), from March 2010 to April 2011 Two different testing offers: Data collected through the pre-test self-administered questionnaire, and analyzed through mixed logistic regressions Objective & Methods CBOffer (n=211, 64%)SMOffer (n=119, 36%) Who?Community membersVCT centres medical staff When?Once a week, outside of opening hoursOnce a week, during opening hours What?Non-medicalized HIV rapid testsELISA and Western blot tests How?Communication campaign in gay venuesFrom among the centres MSM attendees

Findings & implications Factors independently associated with accessing the CBOffer (multivariate analyses controlling for all sites, p < 0.05, n=300) Variables CBOffer % (n=193) SMOffer % (n=107) OR [CI 95%]aOR [CI 95%] Age (median [IQR])33 [26-40]26 [23-36] 1.06 [ ]1.04 [ ] None or 1 HIV test in the previous 2 years (vs. >1) [ ]2.27 [ ] Mean avoidance score 2.5 (<2.5, out of 4) * [ ]0.38 [ ] Casual partners met in at-risk gay venues (yes vs no) [ ]2.62 [ ] Stable housing (yes vs. no) [ ]2.40 [ ] CBOffer: community-based non-medicalized HIV testing offer; SMOffer: standard medicalized HIV testing offer; OR: odds ratio; aOR: adjusted odds ratio; CI: confidence interval; IQR: interquartile range. * The higher the score, the more the participants were able to avoid risk; the lower the score the more participants exposed themselves to at-risk situations. The CBOffer attracted MSM much less likely to have been tested during the 2 previous years... more exposed to at-risk situations Such non-medicalized HIV rapid testing offer performed by community members is feasible and manage to reach MSM who report more sexual risk attitudes Increasing the implementation of such testing offer public health priority Providing counselling centred on sexual risk reduction strategies