Vending machines offering free sexual health tests are offering alternative way to access HIV and STI testing kits in an effort to reach groups who may traditionally face stigma accessing these services.
Vending machines offering free sexual health tests have been placed in venues across Bristol, North Somerset and South Gloucestershire. The machines provide an alternative to the traditional ways of accessing HIV and STI testing kits in an attempt to engage under-served groups.
Getting tests at shopping centres and a cinema
The Unity sexual health service, jointly commissioned by the three councils plus the Integrated Care Board and provided by University Hospitals Bristol and Weston NHS Foundation Trust, set up the vending machine initiative in the autumn.
The machines were placed in four locations, including two shopping centres, an independent cinema, and a creative venue. They contain two types of test kits – one is for chlamydia, gonorrhoea, HIV, and syphilis, and the other is an HIV mouth swab.
Those using the STI test kits are able to send their sample to a lab for free and get the results by text message within one to three weeks. The HIV test provides a result within 20 minutes.
To access a test, a person has to answer six quick questions and enter the code sent to their mobile phone into the vending machine. People can only access a test once every 30 days.
Principal Public Health Specialist Filiz Altinoluk-Davis said: “Like all areas we already had a variety of ways in which people can access tests, including from our clinics and via online ordering.
“But we know there are groups that are not accessing testing as much as we would like, in particular black African groups.”
By making testing more available and easier to access in this way we hope to overcome some of the barriers to testing such as stigma, convenience, accessibility and privacy.
‘Initiative should help us achieve our goals’
A full evaluation is now being carried out by the University of Bristol into the impact the initiative has had and who has been using the vending machines. But they certainly proved to be popular with nearly 1,200 people accessing testing from the machines in the first six months.
Ms Altinoluk-Davis said: “We are pleased with the impact they seem to have had so far – from what we can tell they are proving to be an important part of the way we deliver testing.
“But we now want to see if it has enabled us to reach out to the populations that were not accessing testing and whether the locations we have chosen are the best ones – they are all in areas of greater need but we have had to strike a balance between ensuring there is good footfall and enough privacy for people to feel comfortable using the machines.”
Unity Lead Clinician Sarah Stockwell agrees, adding: “We hope this project will go some way to reducing the number of ongoing infections. Helping communities that find it difficult to access services through traditional channels such as sexual health clinics is a particularly important goal for us.”
Dedicated clinics and health conversations with barbers
The introduction of the vending machines is just one of a package of measures being using to engage local populations and encourage them to take up testing. As a Fast Track City, Bristol is committed to accelerating the work it is doing to end new cases of HIV by 2030 with the council working in partnership with the voluntary sector, university, NHS and service users on a number of projects.
Under Common Ambition Bristol, a three-year programme which has received funding from the Health Foundation, the city is looking at new ways of reaching out to people of African and Caribbean heritage. It is being co-produced with and delivered by the community with a project manager employed by Bristol based HIV charity, Brigstowe.
The initiatives introduced by Common Ambition so far include staff at barber shops being trained in providing brief interventions so they can broach sexual health issues and signpost customers to the right services as well as giving out free condom packs. The programme has also led to a dedicated clinic for people of African and Caribbean heritage being set up which enables them to access rapid testing and HIV therapy PrEP.
Meanwhile, a training toolkit has been set up for health staff called Hearts and Minds. It was developed with a community panel and a community arts organisation and aims to shift the attitudes of staff to help reduce the stigma that people with HIV still face.
Bristol has also recently set up the Enhanced Support Service which provides practical and emotional support for people who have received a positive HIV test but are struggling to access treatment. These people often have a mental health, substance misuse or other social challenge.
These projects are all part of the wider drive to improve sexual health and HIV as part of Bristol’s Fast Track City status. This global initiative has a number of ambitions:
- 95 per cent of people living with HIV knowing their status
- 95 per cent of people with diagnosed HIV on treatment
- 95 per cent of people on treatment with suppressed viral loads (meaning they cannot pass the virus on)
- Zero HIV- related stigma.
The city has already achieved all three measures, but Public Health Medicine Consultant Dr Joanna Copping wants this to be just the start. “We have a fantastic group of partners working collaboratively to address the inequalities we see in our city around HIV and sexual health and to improve our focus on prevention. But there is of course still more that needs to happen.”