Testing, Testing

ADHS pilot project distributes more than 400 at-home HIV test kits throughout Arizona

By Tayler Brown and Kalle Benallie, January 2018 Issue

Rainbow flags hang proudly outside the otherwise average-looking business complex facing 7th Avenue in Phoenix’s Melrose District.

The flags fly as a testament to the strides the LGBTQ community has made to dispel negative stereotypes in its collective quest for acceptance and equality in mainstream society.

Patrick Kelley, owner of the Off Chute Too – a LGBTQ-focused boutique that’s nestled into the south end of the complex, believes that accurate information surrounding HIV/AIDS, such as treatment and transmission facts, has not been taught to the public as much as it should be.

And, in an effort to increase awareness of HIV/AIDS within Arizona, Kelley’s business was one of the locations the Arizona Department of Health Services piloted a Home HIV Test Kit Project throughout the summer.

Kelley has devoted countless hours voicing LGBTQ issues and concerns to local authorities and agencies while bringing awareness to LGBTQ topics. Through this ADHS project, he says he was given the opportunity to bring information on HIV-related healthcare to the community most in need of it.

Patrick Kelley displays Home HIV Test Kits at Off Chute Too this summer.
Photo by Tayler Brown.

According to John Sapero, ADHS office chief of the Arizona HIV Prevention Program, the state health department developed this pilot program as an initiative targeting the MSM segment of the population – due to the associated high-risk sexual behavior – to see if they were willing to receive the test kits and learn about their HIV status.

“Back in the ’80s and ’90s … the stigma of HIV and AIDS was blamed on the gay community,” Kelley said. “We offer testing here because knowledge is power. When you know you have something, [it’s] easier [to] address it.” We tried to make it as easy as possible”

Today, for many millennials AIDS/HIV is seen as an issue of a bygone era, however according to the Centers of Disease Control and Prevention, these health issues continue to affect more than 1 million people nationally.

“The younger generations today are somewhat desensitized to HIV because they didn’t live through the trauma [caused by the AIDS epidemic in the ’90s],” Kelley said. “And they didn’t have to bury their friends.”

The CDC reported HIV/AIDS is still a major health concern in Arizona. Approximately 15 percent of Arizonans with HIV do not know they carry a positive status.

Qualified participants, Sapero explained, included those who had not done an HIV test in the past year as well as those who had never been tested. However, individuals who did not qualify for the program were provided information about alternative locations that provide testing.

Each kit included an oral HIV test (retail value approximately $30), instructions on how to conduct the test, information on the next necessary steps in healthcare after determining their HIV status and tickets offering free HIV testing at healthcare clinics, if participants decided against taking the test at home.

Those who requested kits were required to complete a survey for the ADHS that included HIV status and comments on their experience with the program, which Sapero summarized as positive feedback and words of thanks.

Of the more than 450 requested test kits throughout the state, Phoenix residents requested 106 kits, Tucson residents requested 100 kits and Mesa residents requested 32 kits.

Kits were picked up by MSM of all races and ages with white men requesting the most kits (201) and individuals between the age 18 and 30 being the highest age demographic requesting kits.

Through the pilot project, the DHS was successful in discovering six new cases of HIV in the state – in a short period of time, Sapero pointed out, compared with  HIV testing agencies in Phoenix that examine about 1,000 people a year.

“In eight weeks … we did half of the testing they do in a year,” Sapero said. “We found similar or better positivity that the CDC wants us to have.”

Sapero explained that the magnitude of discovering any new cases helps curb rising transmission rates of HIV because persons unknowingly living with the virus may continue high-risk behaviors, such as unprotected sex, leading to more exposures.

The pilot program only targeted MSM in Arizona, which is only one of many at-risk groups for contracting HIV, according to a study released by the DHS this year on HIV and AIDS in the state.

The same study states that MSM continue to be the minority most heavily affected by the issue; however, infection rates per 100,000 people have almost doubled for African-Americans since 2014.

“We were targeting men who have sex with men on a very specific platform [gay social sites] for a short amount of time,” Sapero said. “We got fantastic results with that, but in terms of cultural appropriateness, language, ad placement it is going to be entirely different if we focus on, say, African American women.”

The HIV Prevention Program has picked up the test kit effort to be part of their HIV testing strategy, beginning in January. And Sapero’s goal for the program is to continue to reach the MSM community in 2018 and then to expand to reach more affected communities.

Phoenix Leading the State

In October 2016, Mayor Greg Stanton encouraged the city of Phoenix to join a U.N. AIDS program called the 90-90-90 initiative, which aims to get 90 percent of people at risk of contracting HIV tested for the virus, 90 percent living with HIV to be on treatment and 90 percent to get the virus under control so it doesn’t progress to AIDS.

Phoenix is the 11th city in the U.S. to be named one of the Fast Track Cities addressing HIV and AIDS issues as part of the initiative.

As a Fast Track City, Phoenix has approved plans to meet the U.N. goals by 2020. In 2017, the Arizona DHS reported it had achieved 85 percent of the first 90 and is working on having the last remaining 5 percent to know their HIV status. The HIV test kit project will become another tool the DHS can use to reach Phoenix’s goals.

Despite the great work conducted over the summer to address HIV and AIDS issues in Arizona, Patrick Kelley still wants more information about the virus to become available to the public.

“Back in the ’80s and ’90s—it seems so long ago but— the stigma of HIV and AIDS was blamed on the gay community,” Kelley said. “We offer testing here because knowledge is power. When you know you have something, the easier you can address it.”

Beyond Arizona 

Damien Salamone, an ASU professor who teaches a class on HIV and works with the HIV/AIDS support nonprofit HEAL International, noted some limitations about the program.

“The beautiful thing about home test kits is that people don’t need to be afraid of the stigma of getting tested,” Salamone said.

But, he continued, because there is still a stigma associated with carrying HIV many people may be unwilling to seek treatment or asking for resources in dealing with their status.

Because the Arizona DHS could give home test kits out freely and have participants agree to report back their statuses through the program, Sapero said they felt successful in their ability to connect individuals to proper treatment and care.

In fact, the success of this program has attracted the attention of other states wanting to implement a similar program in their own communities.

Pedro Coronado, of the Valley AIDS Council-Westbrook Clinic in Harlingen, Texas, wants to implement a HIV home test kit program in Texas. Using the data collected from the Arizona program, Coronado is planning the best method to reaching affected communities for contracting HIV on the border between Texas and Mexico.

“We are in a large rural area,” Coronado said. “So, for people to get to us for testing sometimes it is impossible for them.”

The Arizona HIV test kit program shows great promise in reaching out to rural communities and making HIV healthcare more accessible, Coronado said.