Rapid HIV testing and counseling proves effective at US-Mexico border
Researchers provide mobile testing services
Mobile HIV testing and counseling using the rapid HIV test proved an effective way to reach an at-risk population at the U.S.-Mexico border, a recent study shows.
"With a mobile lab, we tried to reduce the inconvenience and accessibility issues, primarily," says John S. Wiebe, PhD, an associate professor of psychology at the University of Texas at El Paso.
"We did our best to maintain confidentiality in that context, and we removed the necessity of people having to approach a sexually-transmitted disease (STD) clinic during the day," Wiebe says. "The formality of a clinic sometimes intimidates patients."
The rapid testing study resulted in 1,275 HIV tests during a 12-month period from October 2003 to October 2004, and 1.3% were positive for the virus.1
As part of a three-year grant from the Centers of Disease Control and Prevention (CDC) of Atlanta, GA, investigators developed a mobile testing lab. They sent the lab to nightclubs, adult bookstores, and other high-risk locations in El Paso, Wiebe says.
"There were some scheduled times that were advertised at those locations, and also the location was determined to some extent just by the traffic," Wiebe explains. "If the traffic was thin, the staff would move the lab to another location and make maximum use of staff time."
Peer staff recruited people for testing, and care was provided immediately to those who tested positive, Wiebe says.
"Part of the counseling addressed people’s fatalism, and we equipped folks in terms of prevention knowledge," Wiebe says.
More than 81% of the people who were tested in the nontraditional settings were Hispanic, and 10%reported living in Mexico. Also, only 4%had taken a rapid test before, and 27% had never been tested for HIV.1
While the HIV reactivity rate for the study was lower than the clinic’s reactivity rate of 6%, the advantage was that the mobile unit brought in more HIV positive people who had never been tested before, Wiebe notes.
"I think rapid testing can be a very valuable tool for increasing the rate and provision of results," Wiebe says. "It was interesting to us that 19% said they were being tested at that time with a potential sex partner."
The study also found that only 2% of those who were tested said they’d rather have a traditional HIV test than a rapid HIV test, and 93% said they did not experience discomfort in the nontraditional setting, Wiebe says.
The mobile van was sound proof and it had two separate testing areas, so there was little trouble with people maintaining their privacy, he notes.
"Also, 92% said they found the setting at least as private as an STD clinic," he says. "Over 90% said they had no trouble at all with the rapid HIV testing."
Other findings about the people who used the mobile lab’s services were that they were more likely to be men who have sex with men (MSM) and more likely to have been recruited by the staff.
Investigators had expected to have some Mexican citizens use the mobile lab’s services since it was located near the border, Wiebe says.
"The border is very fluid with people traveling back and forth for the weekend," Wiebe says. "Our clinic here is well-acquainted with services available across the border, and can provide services to anyone here who has a Texas address."
However, since there are limited HIV services available across the border, the clinic would work with Mexican citizens if it was a necessity, Wiebe adds.
As the study suggests, a mobile lab providing rapid HIV testing is a way to reach people who haven’t been reached for HIV testing, and it can maximize the use of staff time, Wiebe says.
Reference:
- Wiebe JS, Jones A, Rosenthal S. Rapid HIV testing and counseling in nontraditional settings on the U.S.-Mexico border. Presented at the 2005 National HIV Prevention Conference, held in Atlanta, GA, June 12-15, 2005. Abstract: T2-D0204.
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