Community-based HIV testing in The Netherlands: experiences of lay providers and end users at a rapid HIV test checkpoint

• Published in: AIDS research and therapy Vol. 18; no. 1; pp. 1 - 34
• Main Authors: Krabbenborg, Nori, Spijker, Ralph, Å»akowicz, Anna Maria, de Moraes, Milo, Heijman, Titia, de Coul, Eline Op
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 23.06.2021; BioMed Central; BMC
• Subjects: Accessibility; Acquired immune deficiency syndrome; AIDS; AIDS/HIV; Beliefs, opinions and attitudes; Bisexual; Bisexuality; Community approach; Community health aides; Community health services; Coronaviruses; Counseling; COVID-19; Disease prevention; End user training; End users; Health care; Health care facilities; HIV; HIV testing; Human immunodeficiency virus; Interviews; Key populations; Lay providers; LGBTQ; Medical tests; Methods; MSM; Opening hours; Outpatients; Participation; Populations; Public health; Refugees; Sexual health; Sexually transmitted diseases; STD; Test procedures; Training; Transgender persons; Triangulation; Netherlands
• ISSN: 1742-6405; 1742-6405
• DOI: 10.1186/s12981-021-00357-9

Background The AIDS Healthcare Foundation (AHF-Checkpoint) in The Netherlands offers rapid HIV testing for key populations by lay providers. We explored the experiences and needs of lay providers and end users of HIV testing at AHF-Checkpoint, taking into account the WHO 5C-(consent, confidentiality, counselling, correct-results, connection-to-care) criteria for HIV test services. Methods Qualitative evaluation with 15 semi-structured interviews conducted during 2020 with ten lay providers and five gay or bisexual end users. Recorded interviews were thematically analysed, taking data triangulation into account. Results Four domains were identified: (1) accessibility of HIV testing, (2) quality of test procedures, (3) bridging (transitional care), and (4) future strategies for service delivery. AHF-Checkpoint fills a gap for key populations including LGBTQ and refugees, who experience HIV testing barriers at sexual health centres or general practices. The level of trust between lay providers and end users was highly valued by end users. They appreciated the low threshold to test at no costs, and the absence of waiting lists or triaging. Needs expressed by lay providers included more preparedness for emotionally charged situations, and extra training to improve STI knowledge. End users expressed a need for a full STI test package. Of the 5Cs, consent, counselling, and correct results were realised but confidentiality was sometimes difficult to achieve at pop-up locations, and referral barriers for confirmation testing (connection-to-care) were occasionally experienced by lay providers during weekends. Conclusion AHF-Checkpoint was described as a convenient and easily accessible service by end users and lay providers. Of the WHO 5Cs, connection-to-care could be optimised to ensure HIV confirmation and STI testing through a liaison approach with professionals from the regular healthcare sector. Keywords: HIV testing, Lay providers, Community approach, Key populations, MSM, LGBTQ, Asylum seeker, Migrant populations