Project HelpCenter Tom Platteau Institute of Tropical Medicine Antwerp

History of HelpCenter  Until 2005: partner of CAW Metropool Psycho-social and medical aid for sexual and reproductive health issues.  From 2006 on: partner of ITM to improve access to HIV-test Free of charge consultation and HIV-test External service, not located at ITM  Priority changes towards: Accent on HIV-test (and STI-tests), Reaching specific target groups (MSM, SAM) No long-term follow-up.

Main goal: Secondary HIV- prevention  Increase the number of people living with HIV (PLWH) Who are aware of their HIV-serostatus With access to  Health care  Preventive care Who adopt and maintain preventive behavior for HIV and sexually transmittable infections (STI)  Improve preventive behavior among HIV-negative people with high risk behavior.

Secondary goals  Generate recommendations On a policy level  For political decision makers On a sociological level  For specific (sub-)cultures On an organizational level  For a standard of care for health care providers.

Staff of HelpCenter  Receptionist  Social nurse  Medical doctors  Sexologist  Coordinator

Method Low threshold consultations for sexual health care:  HIV- and STI-tests (anonymously on demand);  Consultations for complaints and questions on STI, pregnancy, contraception, safe sex, …  Psychological and sexological advice and treatment;  Confidential counseling on sexual problems;  An approach that takes intercultural aspects into account, as well as the socially weak position of women, young people and migrants.

Target Groups  Migrants from Africa, Asia, Central and South-America, Eastern- and Central Europe…  People with a difficult access to regular health care (young people, difficult relationship with GP)  People with high-risk sexual behavior  People who are seeking an anonymous HIV- or STI-test

Activities  Medical consultations  Sexological consultations  Operational research (to generate policy guidelines)  Specific projects: Rapid HIV-test since June 2007 Outreach testing in preparation phase

Co-operation  HIV-SAM: “Muungano” in HelpCenter (patient-group for African migrants living with HIV) Attendance of an African doctor to provide culturally sensitive counseling at HelpCenter  Sensoa: Publicity towards MSM  Others: De Acht, AZG, CLB,…

Results January - June 07  Medical consultations: 274 patients 159 patients had HIV-test (58%) 532 patient contacts Mean: 20,5 consultations per week

HIV-test January – June 07  159 patients had HIV-test  88 males, 71 females  1 test HIV-positive  38 (23,9%) had an anonymous test  121 (76,1%) not anonymous

HelpCenter patients Health Insurance (N=266)

HelpCenter patients Origin (N=274)

African patients  Total of African patients: 45  Sex of African patients: 14 male 31 female  25 African patients had HIV-test (11 male, 14 female)  Anonymous vs not anonymous: 2/25 (8%) vs 23/25 (92%)  Percentage anonymous among African patients (8%) < overall percentage (23,9%)

African patients Reasons for consulting HelpCenter

African patients Reason for having an HIV-test

Conclusions  HelpCenter reaches its socially vulnerable target group: 40% has no health insurance  Anonymous testing is, in contrary as expected, more requested by people with health insurance (socially less vulnerable). Therefore, fixed sum (€20) for anonymous STI check-up is requested.  Additional efforts to reach target groups in order to increase number of tests are necessary.

Acknowledgements  Kristien Wouters  Christiana Nöstlinger  Filip Moerman  Chris Van Ghyseghem  Ilse Collier