Gift cards, free meals offered in Vancouver HIV-testing project

Downtown Eastside residents are being offered $5 Army and Navy gift cards to get tested for HIV in parks and hotels, part of a five-month experiment aimed at boosting testing and early diagnosis among drug users in the neighbourhood.

Called Status, the provincially funded project held festival-style park events in June and last weekend offering free meals, live bands, and the testing. Organizers say gift cards were chosen as an incentive because at-risk people are less likely to exchange them for drugs.

The service is being offered in single-room-occupancy hotels as well. The goal is to test 5,000 Downtown Eastside residents – the estimated number of drug users in the neighbourhood – by the time the program wraps up at the end of October. Just 3,000 HIV tests were conducted in the Downtown Eastside during all of 2010. “What we’re doing here is not enough, but it’s a start,” said Mark Townsend, executive director of the PHS Community Services Society, which co-manages the supervised drug injection facility Insite and was contracted by Vancouver Coastal Health to run the pilot project. “Our agenda is to test as many people as possible and get as many as we can into treatment.”

The B.C. Centre for Disease Control is cautiously optimistic that HIV incidence among injection drug users across BC has decreased in recent years, likely because of increasing coverage of effective antiretroviral therapy, and harm-reduction programs. Testing blitzes like Status, organizers say, are an opportunity to ensure the numbers keep going down. Sixteen new HIV cases have been identified from the 2,500 tests performed to date through the Status program. On Aug. 13, the first day of a weekend testing event at Oppenheimer Park, three new positive diagnoses were made, 30 previous positives were confirmed, and 450 people tested negative. All testing was done in a gated, access-controlled circle of a dozen tents by Vancouver Coastal Health nurses and trained community members.

Many people DTES residents don’t have e-mail, phones or alarm clocks, said Mr. Townsend, which makes standard approaches to HIV testing and follow-up difficult. “But it’s easy to test and follow people as long as the service is tailored to them.”

To that end, 30 members of the community have been certified to provide pretest screening and administer the HIV tests. Pascale Wolf, a 44-year-old Downtown Eastside resident who underwent 20 hours of training, said many locals do not trust doctors. “I’ve been able to get people who are quite ill, who I know have shared needles, to come and get tested. We have a relationship already.”

Ms. Wolf has been trained to use a 60-second HIV test kit developed and manufactured in Richmond B.C. It was first used in Vancouver in 2009, and is now available in at least 50 countries. The test is ideal for Status because it can detect antibodies to the HIV virus from a tiny drop of blood, and, unlike traditional tests that can take weeks to produce results, it works in one minute.

The success of Status will ultimately be measured by how many new positives can be identified, and importantly, how early the diagnoses are made in the disease progression. Vancouver Coastal Health Medical Health Officer Reka Gustafson said Status is just one of 32 pilot projects focused primarily on Vancouver aimed at getting people from all communities – not just the Downtown Eastside – tested and diagnosed earlier.

“We’ve gotten complacent about HIV testing and we think everything is fine,” she said, noting that 300 to 400 British Columbians will be diagnosed with HIV this year. “But 60 percent of people are diagnosed well after they should already be on treatment, so we know things are not fine at all.”