CONNECT - Rapid HIV Testing Program

A Free HIV Self-Testing Project

Words by Jenny Jung

SAMESH, short for South Australia Mobilisation + Empowerment for Sexual Health, is a partnership program between SHINE SA and Thorne Habour Health. It aims to bridge the concerning gap that exists in SA’s sexual health services, in education, training and advocacy for multi-cultural, gender diverse experiences. HIV has never been more preventable and treatable, and SAMESH is dedicated to delivering these tools so that HIV becomes a thing of the past in SA.

Their CONNECT project may be the most innovative cure to the inaccessibility of HIV testing yet. SAMESH is piloting several vending machines across SA that provides free Atomo HIV Self-Test kits and thus eliminating various barriers to getting tested. Its target groups include gay men and other men who have sex with men, migrants, and international students. Their project has been consulted with a cultural advisory group to ensure that it is culturally sensitive, and even the instructions are available in eight different languages.

Dr Nikki Sullivan, is the project coordinator of the CONNECT program on SAMESH’s end, where in partnership with other service providers and support services, she drives the project. Before coming to SAMESH, Nikki was an academic at the Macquarie University in cultural studies for 25 years, with an expertise in queer culture, and LGBTQI history and practices. She left the university sector to return to Adelaide and work for the history trust of SA. She was first the curator of the Migration Museum, then a manager at the Centre of Democracy. Across all her roles, her main focus - her life focus - has always been inclusivity, and advocating for marginalised groups. She began working with SAMESH as a volunteer when she was offered the role of project coordinator. I met up with Nikki to discuss the CONNECT project and gain some insight into the culture around HIV testing.

While the culture has shifted to being more sex-positive and encouraging of STI testing, HIV testing is often overlooked, feared, or brushed off as irrelevant. How do you think this approach came to be, and how relevant do you think HIV testing is for the young people here at university?

I think that from the beginning of the epidemic, really, there’s been this association of HIV with particular groups of people. So initially, back in the 80s, they used to talk about the 4 H’s: Homosexuals, Haemophiliacs, Heroin users, and Haitians. So basically, it was racist. - It was like ‘these are the 4 groups of people who are most likely to get HIV and they’re all people we don’t care about’. I think what has stuck from those years is the association of HIV with gay men and with intravenous drug users. So I think people who don’t identify as gay men or don’t use intravenous drugs, think; ‘It’s not something I’m going to get’. But actually that’s not the case at all. If you look at the different situations in African countries you’ll see they are very different to the situation in Australia, where historically it has been that gay men have been much more likely to become positive than heterosexual people. What we now see in some

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states in Australia, is that the positive cases are becoming more common for heterosexual people than they are for gay men. That still isn’t the case in SA yet, but it’s definitely something that people need to be aware of. People often think, ‘HIV - that happened a long time ago to gay people’. Well, no, it’s still happening to all kinds of people right now. It came about in response to the federal strategy that was attempting to address blood-borne viruses and STIs. As a part of that, there was a pot of money there that organisations like ours could apply to tackle any of those issues. So, SAMESH is kind of like the child of two parent organisations - SHINE SA and Thornhabour Health, which used to be the Victorian AIDs council. Basically, those organisations applied for this money to run this program.

International students are stressed as your target demographic for this project. How can international students in particular benefit from the HIV self-testing kits?

The reason that we are trying to engage the constituencies we’re trying to engage is because what the research shows - whilst transmission rates are relatively stable amongst Australiaborn or long-term Australian residents, they’re on the rise amongst people who are here on temporary visas. In particular, people from South East Asia and the Sub Saharan African regions. The research identifies those groups as particularly vulnerable. There is a lot of research that shows that international students often find themselves in a culturally very different context, in which sex might be something that’s much more openly engaged in. They may not have had a whole lot of sexual health literacy and therefore they may engage in practices that are not particularly safe. There’s lots of reasons why these particular demographics are perhaps more vulnerable than others.

Another thing is that there’s a lot of barriers for testing, particularly for international students. International students are not eligible for Medicare, which means that if you want to go get a test, you charge it to your private health insurance - which may be connected to your parents private health insurance. That’s a big deal, nobody wants their parents to know they’re getting an HIV test or an STI test. People often just don’t have the money to pay upfront. There’s lots of stigma, and there’s also people that maybe come from cultures where these things are less openly discussed. For anyone, actually going and saying to somebody ‘I want to test for an STI/HIV’, may be just too difficult. These pilots using vending machines have been run in the US, UK and NZ, and what they show is that they overcame some of these barriers; they overcame the cost barrier, the time barrier - students are studying and working, when do they get time to go to clinics? - it overcame the fear of having to engage with somebody because you can just go and get it without talking to anyone. You can take it home, you can do it in your own time.

Do you believe that there is a significant gap in the conventional sex education curriculum of today in terms of sexual/gender/ cultural diversity?

I think it depends on where your education comes from. I think increasingly, in Australia, if you’re not in a religious-based school, you are likely to have had some sex education - it’s often not great, though. I think that oftentimes people, particularly young people don’t have the confidence to talk honestly even amongst themselves. Oftentimes, amongst your friends there’s a bit of bravado, or you don’t want to appear like you don’t know something. This is an interesting initiative because it isn’t just about getting people to do this one test. It’s about trying to educate people such that regular screening becomes part

of the whole thing - You don’t just test when you think you might have something, you should actually be screening on a regular basis and practicing safe sex. So you can have a healthy sex life and stay healthy as a person.

So it’s like, by people seeing these machines pop up, and people start testing more regularly, it initiates a cultural shift as well, not just targeting certain demographics.

Yeah, it’s not like, ‘these are just walk-in clinics because that’s where you go’. It’s like ‘No, these are out in the open because this is part of our everyday life’. Just like how we go buy drinks because we all need to drink liquid. We don’t all have sex, but a lot of people do - this is just part of that. Making them available freely is really important because of course, cost itself is a big barrier for people.

Up until the end of last year, the only way you could really get them was online and they cost you $25 plus postage. Then at the end of last year, the Therapeutics Goods Administration changed the regulations around self-test kits. There’s only one that they recognise, which is the one that we use. Since then, they’ve become available in some chemists, but if you go into a chemist and buy one I think they cost you about $25. But also, there’s no support network around that. So what we do, is to not just give out the packs, but provide a whole range of information about what to do when you get a positive result - it doesn’t necessarily mean that you are positive, you can get a false positive result - what to do if the kit doesn’t work, what to do if you get a negative result - which is great but you should do it again in another 3 months time.

To wrap up, can you tell our readers how they can access the HIV self-testing kits on campus, and how it works?

There’s two vendors available on campus at Adelaide Uni - one on level 2 and one on level 3 of the Hub. One is in a much more open area by all of the other vending machines, and one is in an all-gender bathroom - that’s completely private if you don’t want anyone to see that you’re getting one. When you see the posters or an ad in the paper or on a bus, you scan the QR code - or, you might be walking past the machines, and you can scan the QR code on the machine. You’ll get taken to a web app which will say to you: ‘This is the CONNECT program, we give out free HIV test kits. Do you want one?’. Then, if you say yes, it will ask you four questions: Country of birth, age, have you ever tested before, and sexuality. You have to supply a mobile phone number, but the really important thing to stress here is that for us, those numbers are not traceable to anybody. All the data that is collected is stored in accordance with all the privacy laws - they’re never going to be able to connect it to you.

Then, it sends you a 4 digit code that you put into the web app. It goes ‘right, we recognise you now, you’re registered’. If you are near the vending machine, then just go scan the QR code. If you’re not near the vending machine, you can close that on your phone, and the next time you find yourself near the vending machine, you can scan the QR code and then it will vend out the kit for you.

You can go to any of the machines. While there are two here, there’s also one at the City West UniSA campus in the student lounge, there’s also one at UniSA Mawson campus in their student lounge. There’s one at Pulteney Sauna, which is a men’s sauna on Pulteney street. If you want more than one kit, you just scan a second time - you don’t have to register all over again, once you’ve registered it will recognise your phone number. You can do that up to about 7 times. One of the things we learned from one of the pilots that was carried out in the UK is that if you don’t put a limit on the number of kits you can get, what can happen is that you have this informal kind of distribution network. You might have friends who are like ‘I want to test, but I really don’t want to be seen going to get one’. So you can say ‘Well, I’m going to get one, how about I get one for you as well?’. We want that to be able to happen. The other thing is, you might get a kit, then you might go home and feel a bit lacking in confidence when it comes to doing it and you might want to go back and get another one.

It’s a really easy process, then 7 days after your first registration, you’ll get a follow up SMS asking if you’ve gone and collected the kit and used it. If you have, there’s a URL to a follow up survey, but you’re not obligated to fill out the survey. If you are willing then that’s fantastic, because then we can collect data. Not that it’s identifiable but what we want to know is how easy it was for people to use, would they use it again or recommend it to people, and if they want to see this project ongoing. We need that data because we will report back to the Commonwealth at the end of the project and we will be making recommendations for continued use if these prove to be useful for people.

Do you have any other comments for our readers?

Anybody that has unprotected sex, anybody who uses needles, is vulnerable. There’s nothing to be ashamed of. It’s just in the same way how now we are all testing for COVID - I think this is just going to become a part of life. We will have much more agency when it comes to our own health. It’s a great initiative - please use it! Don’t feel ashamed or embarrassed. If anyone has any questions, we have a website with lots of information on it.

Visit SAMESH’s website for more information on CONNECT, as well as their services.

www.samesh.org.au

www.samesh.org.au/connect-free-hiv-kits/