SOLO: Reaching Toronto-area African, Caribbean and/or Black communities with HIV self-testing

Initiative Summary

The HIV Self-Testing Community Outreach and Localized Outcomes (SOLO) study aims to mitigate the risk created by COVID-19 to ensure that people from ACB communities in the GTA have access to timely, unrestricted HIV testing and care to support their health and well-being.

African, Caribbean and Black (ACB) communities in Toronto are disproportionately affected by HIV, and because of health inequities, racism and stigma, face significant barriers to accessing HIV testing as well as connections with healthcare providers (HCP) and engagement/retention in care. COVID-19 has made this situation even worse as many testing sites have been effectively shut down, and healthcare access is even more limited. A number of testing centres in the Greater Toronto Area (GTA) have reduced hours and have instituted appointment-only options for service users with urgent concerns. Others have closed HIV Testing Clinics until further notice due to the pandemic.

The decline in HIV testing has been linked directly to the pandemic globally, with UNAIDS reporting disruptions to HIV testing and linkage to care since the start of the pandemic based on the reporting of 57 countries. At the regional level, the Pan American Health Organization (PAHO) recently endorsed an advocacy campaign to increase self-testing among Caribbean nations alongside UNAIDS in response to the COVID-19 pandemic.


Women’s Health in Women’s Hands (WHIWH) in partnership with REACH Nexus and the MAP Centre for Urban Health Solutions at St. Michael’s Hospital, will lead the SOLO study and provide support program for expert peer HIV testers at WHIWH to provide culturally appropriate engagement and counselling to 2,500 ACB people in Toronto and support them to access HIV self-testing kits, HCPs, connections to—and engagement with—the health care that will serve their needs.

Initiative objective and goals

The partnership between WHIWH, REACH Nexus and the MAP Centre for Urban Health Solutions will provide the necessary support for the implementation and evaluation of this program intervention to determine its effectiveness in reaching ACB people in the GTA who are most at risk for HIV and related health conditions to get tested for HIV.

We will collect data on numbers of new HIV infections, successful linkages to HCPs and care, acceptability of this intervention, and the degree to which it can reduce stigma and health inequities. If successful, we will work to secure additional funding and supports for its implementation and scale-up in other major urban centres where ACB people live (Halifax, Ottawa, Montreal, Winnipeg and Calgary).

Specifically, the objectives of this project are to:

  1. distribute 2500 INSTI HIV Self Tests to members of African, Caribbean and Black communities in the GTA;
  2. provide support for participants to get connected to appropriate care based on test results (i.e., provision of confirmatory testing at WHIWH CHC and linkage to care for confirmed positive cases);
  3. evaluate the participants’ experiences with the INSTI HIV Self-Test; and
  4. evaluate the program as a mechanism for kit distribution to ACB communities in the GTA.



MEANINGFUL ENGAGEMENT WITH PEOPLE WITH LIVED EXPERIENCE

People with ACB backgrounds in Toronto and surrounding areas are significantly impacted by COVID-19 restrictions. As in-person visits and point-of-care testing for HIV continue to be limited at this time (and in some cases nonexistent) due to COVID-19, it’s important to find new ways to get new testing technologies to these communities. The co-leadership of Women’s Health in Women’s Hands, a community health centre that focuses on the needs of ACB populations in Toronto, will ensure that the needs of ACB populations are captured and met with this project.

Key performance indicators

PRIMARY TARGET AUDIENCE

People over the age of 18 years old that identify as African, Caribbean or Black (ACB)

Start Date
October 22, 2021
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Strategic marketing and support tactics

Participating sites will advertise for study recruitment via posters within the clinics, and also through their respective social media channels.  

In addition to recruitment by community-based organizations, WHIWH CHC will use community health ambassadors to provide HIV prevention, information and outreach to community members.

RESULTS

Findings from this study will be shared when they become available.

Results

Findings from this study will be shared when they become available.

Insights

Challenges