1. Elisa: free and anonymous hiv testing Lessons learned

2. Elisa centre of Médecins sans Frontières Start 1989 Objectives: -reach at risk groups -making testing easy -primary prevention Since 1992: + 2000 tests/year 2006: public funding and handover

3. Primary prevention pre- and post counselling continuity few numbers (0.29% of all tests) At risk groups

4. Making testing easy Specialised centre (15 %) Accessibility (30 %) Free of charge (50 %) Anonymous testing (60 %)

5. Free of charge 50 % of all consultants IDU: 64.8 % Heterosexual women: 63.4 % Younger than 20: 71.1 %

6. Anonymous testing 60 % of all consultants MSM: 70 % Younger than 20: 65 %

7. Anonymity Freedom of speech Don’t trust confidentiality Fear of discrimination Extra-marital relation If positive, to choose when and whom ( to tell, treatment)

8. Reach at risk groups: Infections rate: 11.1/1000 tests 7 times rate in confidential testing

10. Risk factors Age : > 30 years Nationality: sub–saharan or european non- belgian MSM IDU

12. Risk groups Sub-Saharan nationalities: 8.1 % (women: 12.1 % ; men: 5,6 %) MSM: 2.2 % Sub-S and MSM: 90 % of all cases

14. Conclusions Importance of free and anonymous testing Acknowledge risk groups Risk groups: how to reach them, how to teach them ?