With the rate of HIV diagnoses stubbornly sitting at high levels and a resurgence of Syphilis diagnoses through the latter part of 2015, the WA AIDS Council met with Department of Health staff, HIV and sexual health specialists, and GPswith an interest in HIV to look at ways to address these issues. Further to this, the WA AIDS Council has developed an HIV/STI action plan that will enhance its existing programs and has launched a comprehensive media intervention strategy.
A particular focus were men defined as ‘hard to reach’; those that do not have a high level of engagement with the social and sexual networks accessed by gay and bisexual men (GBM) more generally.
The HIV/STI Action Plan was launched in April and had four overarching objectives:
1. Reduce new STI infections amongst Perth GBM
2. Increase the number of GBM accessing sexual health screening in general practice
3. Increase the number of GBM using PrEP
4. Improve our understanding of current epidemiological trends amongst GBM
A major emphasis has been given to advertising on several popular gay dating apps, including Grindr and Scruff. These are supplemented by two other apps not previously used; fridae.asia and squirt.org. These two are interesting because their content is user-generated and in the case of fridae, originally established as a sexual health promotion initiative for gay and bisexual men from Asian countries and other men interested in meeting them.
Supplementing the paid advertising has been the establishment of user profiles “The Sexpert”, which invites questions about sexual health and related topics. So far the interest (as measured by numbers of questions asked) has been higher than expected. This initiative will continue.
PrEP and increasing its use is represented by two related initiatives. “PrEP: Easier than you think” is a video-based campaign that promotes an understanding that even if not subsidised under the Medicare Benefits Scheme, PrEP is easily and relatively inexpensively accessed in WA. We ‘re supporting this with the WA PrEP Access Program, which in collaboration with other clinical services, is a pilot program designed to streamline initiation and ongoing management for patients who feel that this bio-medical prevention is right for them.
All activities encompassed by the action plan are designed to increase the rate of testing for those men most vulnerable to HIV or other STIs, and we have given consideration to how and where testing can be delivered within already stretched testing infrastructure. General practice already provides a significant proportion of sexual health screening, but we believe that this is disproportionately driven by symptomatic cases, and we want to encourage more men to consider using their GP for regular non-symptomatic testing. We know that there are barriers here, where some gay men feel uncomfortable discussing their sexual practices in this setting and therefore may not be prescribed the full suite of tests that we recommend. Our answer has been to develop a campaign to reduce the ‘awkwardness’ that is reported as common to both patients and doctors. Again, this is video-based and downloadable resources allow a patient to provide their doctor with a request that specifies the precise range of pathology required. As more men access their doctors through this campaign, more doctors will become better familiar with what gay and bisexual men need to maintain their sexual health.
Altogether, the initiatives incorporated into the HIV/STI Action Plan are the most targeted and comprehensive program aimed at gay and bisexual men in many years. Given the wide use of social media across all elements, tracking outcomes will be more precise and enlightening than in any previous campaign. Running initially through until the end of December, we will be reporting regularly on what we are learning, and how the epidemiology is responding.