Free HIV test entitles you to one movie pass
Los Angeles clinic’s model to be tested elsewhere
As any restaurant owner will tell you, the best way to increase business is through word of mouth. Friends tell friends to check out a place, and this helps the business grow in popularity. Using the same philosophy, a Los Angeles clinic attracts new patients who are at risk for HIV infection and have never been tested.
Called the "Bring in a Friend" program, the model works so well that it has attracted interest from drug companies that may set up similar programs in other cities, says Wilbert C. Jordan, MD, director of the OASIS Clinic and AIDS program at King Drew Medical Center in Los Angeles.
Jordan came up with the idea after talking with a patient who was a drug user, who pointed out that none of the people waiting in line to be tested for HIV were the people he shoots up with.
"I said, Can you bring them in?’" Jordan recalls. "He said, Yeah, for $10,’ and I said, OK, I can’t give you $10, but I’ll give you a pass to the movies,’ and so he brought them in."
Following up on that small success, Jordan and colleagues at the OASIS Clinic began to ask other HIV patients to bring in their friends to be tested in exchange for movie passes.
"We had one patient bring in 22 people, and 15 were positive, so we got high numbers of positives," Jordan says.
The program’s method of attracting people who are at risk for HIV appears to be highly successful. Of people who came to be tested through the friend referral program, 48% were positive, Jordan says. This compares with a positive rate of 1.5% in the Los Angeles County’s program in which individuals can come in for anonymous, confidential testing.
Jordan presented data from a study of the program at the 37th Annual Meeting of the Infectious Diseases Society of America, held in Philadelphia in November 1999.
Jordan asked 31 HIV-positive patients at the OASIS Clinic to bring people who might be at risk for HIV in to the clinic for free testing and counseling. Patients brought in 79 people, and 77 stayed for the testing. Thirty-seven of those who were tested were HIV-positive.
For 66 of the 77 people, this was their first HIV test. The 11 people who had been previously tested were still HIV-negative. Of the 37 HIV-positive patients, 35 have begun antiretroviral therapy. Three of the 37 patients were female; 24 were men; and 10 were transgender, meaning they were men who were living as women. Most of the patients were African-American or Hispanic, and most of the men reported having sex with men.
The OASIS Clinic serves a population that is mainly African-American and Hispanic, and the friend referral approach works well with people in these communities, Jordan says.
"There’s a lot of anxiety in the gay community and gay black community about names reporting," he explains. So at-risk minorities are more likely to trust a friend when told to come in for a confidential HIV test.
"I’m just amazed at how much better and more cooperative people are when they come in with someone to be tested," Jordan says.
Also, the HIV patients who make the referrals often are hanging out in the places where at-risk people might be, including bath houses, parks, shooting galleries, and sex clubs. They also know who has just been released from jail and may have become infected while behind bars, Jordan says.
The program’s referral method also gets around the problem of finding men who have sex with men but don’t identify themselves as being gay or bisexual. Typical methods for finding at-risk gay men would target gay hang-outs. But some of the men who engage in gay behavior either would ignore messages aimed at these groups or may not visit these places. Still, they may have gay friends who know that they are at risk and need to be tested for HIV, and they might follow their friends’ lead on being tested.
Another benefit of the program is that Jordan has observed that the people who become HIV patients after being referred by a friend for testing are more compliant patients. "They see that their friends who bring them in are relatively healthy and are doing well from treatment," he says.
About 95% of the referrals sought treatment within a week or two of finding out they’re positive, and 80% of them stayed with the OASIS Clinic, Jordan says.
"I was not expecting that to be a benefit, but it’s a big benefit," he adds. "If you’ve been kind of wishy-washy about treatment and then you bring in a friend, then you both will do better and be more compliant."
The program’s only expense is the movie tickets. The person who brings in a friend is given a movie pass, and the friend is given a movie pass. Drug companies have paid for the passes.
"I tell drug reps that rather than bringing us food, bring us movie passes, and they do that," Jordan says.
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