Project HelpCenter

Tom PlatteauInstitute of Tropical Medicine Antwerp

History of HelpCenter

Until 2005: partner of CAW Metropool Psycho-social and medical aid for sexual and

reproductive health issues. From 2006 on: partner of ITM to improve

access to HIV-test Free of charge consultation and HIV-test External service, not located at ITM

Priority changes towards: Accent on HIV-test (and STI-tests), Reaching specific target groups (MSM, SAM) No long-term follow-up.

Main goal: Secondary HIV-prevention

Increase the number of people living with HIV (PLWH) Who are aware of their HIV-serostatus With access to

Health care Preventive care

Who adopt and maintain preventive behavior for HIV and sexually transmittable infections (STI)

Improve preventive behavior among HIV-negative people with high risk behavior.

Secondary goals

Generate recommendations On a policy level

For political decision makers On a sociological level

For specific (sub-)cultures On an organizational level

For a standard of care for health care providers.

Staff of HelpCenter

Receptionist Social nurse Medical doctors Sexologist Coordinator

Method

Low threshold consultations for sexual health care: HIV- and STI-tests (anonymously on demand); Consultations for complaints and questions on

STI, pregnancy, contraception, safe sex, … Psychological and sexological advice and

treatment; Confidential counseling on sexual problems; An approach that takes intercultural aspects into

account, as well as the socially weak position of women, young people and migrants.

Target Groups

Migrants from Africa, Asia, Central and South-America, Eastern- and Central Europe…

People with a difficult access to regular health care (young people, difficult relationship with GP)

People with high-risk sexual behavior People who are seeking an anonymous

HIV- or STI-test

Activities

Medical consultations Sexological consultations Operational research (to

generate policy guidelines) Specific projects:

Rapid HIV-test since June 2007 Outreach testing in preparation

phase

Co-operation

HIV-SAM: “Muungano” in HelpCenter (patient-group for

African migrants living with HIV) Attendance of an African doctor to provide

culturally sensitive counseling at HelpCenter Sensoa:

Publicity towards MSM Others:

De Acht, AZG, CLB,…

Results January - June 07

Medical consultations: 274 patients 159 patients had HIV-test (58%) 532 patient contacts Mean: 20,5 consultations per week

HIV-test January – June 07

159 patients had HIV-test 88 males, 71 females 1 test HIV-positive 38 (23,9%) had an anonymous test 121 (76,1%) not anonymous

HelpCenter patients Health Insurance (N=266)

0

20

40

60

80

100

120

140

160

180

C o vered

N o t co vered

HelpCenter patients Origin (N=274)

0

20

40

60

80

100

120

140

W estern E u ro p ean

L atin A m erican

A frican

A sian

E astern E u ro p ean

N o rth ern A m erican

U n kn o w n

African patients

Total of African patients: 45 Sex of African patients:

14 male 31 female

25 African patients had HIV-test (11 male, 14 female)

Anonymous vs not anonymous: 2/25 (8%) vs 23/25 (92%)

Percentage anonymous among African patients (8%) < overall percentage (23,9%)

African patients Reasons for consulting HelpCenter

0

2

4

6

8

10

12

14

16

E asy access

F ree o f C h arg e

S p ecialized cen tre

A n o n ym o u s

African patientsReason for having an HIV-test

0

2

4

6

8

10

12

14

P erso n al co n cern

S p ecific risk

N ew relatio n sh ip

R eferral

Conclusions

HelpCenter reaches its socially vulnerable target group: 40% has no health insurance

Anonymous testing is, in contrary as expected, more requested by people with health insurance (socially less vulnerable). Therefore, fixed sum (€20) for anonymous STI check-up is requested.

Additional efforts to reach target groups in order to increase number of tests are necessary.

Acknowledgements

Kristien Wouters Christiana Nöstlinger Filip Moerman Chris Van Ghyseghem Ilse Collier