NEW AfA PROJECT – THE MOBILE HIV TESTING & COUNSELLING SERVICE (MTS)

Launched in 2011, the Mobile HIV Testing and Counselling Service (MTS) aim to make anonymous HIV testing more accessible and convenient to members of the public. This project is our latest effort to increase the accessibility of HIV testing in Singapore. This community project is sponsored by the MAC AIDS Fund and supported by Ministry of Health, Ministry of Community, Youth and Sports, and the Department of STI Control.

The MTS van is the first in Singapore and is an extension and expansion of the Anonymous Testing and Counselling Service (ATS) based in the DSC Clinic in Kelantan Lane. The ATS, which operates three times a week, is the busiest of the seven anonymous HIV test sites in Singapore approved by MOH.

Each year, more than 400 people are newly diagnosed with HIV. Although HIV testing is widely available in Singapore, 54% of newly diagnosed patients with HIV in 2010 were already in late-stage of HIV infection when they were diagnosed. Furthermore only 12% of infections were detected through voluntary testing. Early detection of HIV infection is essential as this reduces the chances of people spreading the infection unknowingly. Starting treatment earlier has been shown to improve health outcomes, significantly delay the onset of AIDS and allow infected persons to continue to lead active and productive lives. Therefore the provision of the MTS to the community will make it easier for members of the public to access HV testing.

Changing Mindsets
We hope that the convenience of MTS will contribute to efforts to encourage the adoption of routine HIV testing and to make it a part of sexual responsibility. It is important for individuals who are sexually active to go for testing regularly. We hope that members of the public will become more proactive and open to HIV testing. The MTS taglines that we have adopted and hope to publicise are “Know Your Status - the life you save could be your own” and “Knowledge = Life”. We hope that these will strike a chord as they underline the importance of HIV prevention and early diagnosis for treatment.

MTS Van Set-up
The interior of a hybrid van, Toyota High Roof Hiace, has been converted into a counselling and testing room with complete clinical facilities to conduct rapid HIV and syphilis tests. The van will be manned by 2 trained staff who will facilitate counselling and provide testing services. Volunteers will be on site to answer public queries and to introduce the service to interested persons. Results of the rapid HIV and syphilis tests will be ready within 20/60 minutes. Tests will be performed in strictest confidence and will be anonymous.

Want to find out more about MTS?
The MTS service can be offered at a variety of locations. Through active outreach, AfA will work with agencies, community based groups and companies to bring the MTS to as many venues as possible. Ownership and collaboration with stakeholders are necessary to make HIV testing as non-threatening as possible. The timing of the service will be catered to needs of various groups. The operating hours will be flexible. The MTS van will also be parked at targeted locations in order to complement with AfA’s outreach programmes.

Businesses, organisations and health/lifestyle event companies interested to find out more can get in touch with us via email at mts@afa.org.sg.

To commemorate the launch of our services and as an introduction of MTS, we will be providing complimentary HIV testing for a month.

UPDATE ON THE HIV/AIDS SITUATION IN SINGAPORE
Characteristics of new cases of HIV infection
*Source from 2008, 2009 and 2010 press release from Ministry of Health.

MTS ONSITE TESTING WORKFLOW

• STEP 1: INTRODUCTION, CANVASSING AND PROMOTING
  • Volunteers on duty will canvass the area in sight of the van. They will promote MTS service by distributing pamphlets and encourage people to get screened. Clarifying to the clients about the window period for HIV testing or the window. Those who wish and agree for testing will referred to Coordinator as a queue.
• STEP 2: PROFILE REGISTRATION
  • Coordinator will assign client an anonymous questionnaire to fill up the profile section. Once they have completed the profile, coordinator will direct client to proceed to the van. There will be an electronic indicator to indicate rooms’ availability.
• STEP 3: REGISTRATION & TEST PROCEDURE
  • Client will proceed to van with the anonymous questionnaire profile filled. Once the client is in inside, Counselor will process the logistics:
    • for payment/ complimentary coupon or other arrangement. Each test is 30/- cash only
    • for the desired mode of testing: HIV Oral Swab or HIV Blood or/and Syphilis Blood
  • Counselor will assign a unique serial and a receipt/ID card to client as an identification.
  
  • Counselor will perform the test procedure to client:
    • OralSwab:
      • Counselor will take them through the test procedure.
      • Counselor will indicate the time on the test kit once it is done and placed the kit for safe keeping for 20/60 min.
    • Blood:
      • Counselor will proceed to perform pricking procedure.
      • Disinfect the client’s test fingertip with alcohol swap.
      • Dry the disinfected fingertip before ‘Lance’ the fingertip.
      • One or two full drop of blood (approx 5ul) is placed on HIV-antibody or/and Syphilis-antibody test strip.
      • Provide client with cotton wool or any other absorbent to compress the puncture.
      • Apply band aid a plaster on the finger.
      • Counselor will indicate the time on the test kit once it is done and placed the test strip for safe keeping for 20/60 min.
    • Infection Control
      • Only sterile & disposable equipment are used for this procedure, including gloves, needles, HIV test strips, plasters and cotton wool.
• STEP 4: COUNSELING
  • Once the test procedure is done, Counselor will start counselling session and all information provided is kept anonymous & confidential. For the purpose of doing an HIV risk assessment, counsellor will ask some personal questions about your sexual risk behaviour. Some notes may be taken down on the form, but this will still remain anonymous & confidential. You should take this opportunity to ask your counsellor any questions you have about HIV, safer sex or sexual health.
  • Once the counseling is completed and no further question from clients.
• STEP 5: RESULT
  • ABOUT 15/20 min [from the time written on the test kit: Oral Swab or Strip]
  • Counselor will explain the result of the test for HIV to client.
  • LESS than 15/20 min [from the time written on the test kit: Oral Swab or Strip]
  • Counselor will explain to client to call MTS for result. The details of the information when and where to call is on the receipt/ID card to client earlier together with a unique serial and a password as identification.
  
  RESULT CALL BACK
  • 60 min later client will call MTS hotline: 9734 2230, Client has to quote receipt/ID card with a unique serial and a password as identification.
  • Once verified, Coordinator/Counselor will verbalise the result to client. NO SMS of the result will be allowed.
  • Coordinator/Counselor will note the time of the result announced on the summary list.
  
  NON-REACTIVE (NEGATIVE)
  • Counselor will provide the “Stay Negative” leaflet and condom to clients.
  
  REACTIVE (POSITIVE)
  • Counselor will counsel the client, explain and arrange for the process of Confirmatory Test: WB to be done another day.
  • Counselor will advise client to abstain from sexual contact until the confirmation is ready (around 10 days) and advise them of their legal obligation to inform all sexual partner(s)’s status and to adapt strictly safer sexual behavior.
  • Provide client with a HIV positive guide-book: A Different View Changes Your Life for better understanding of HIV/AIDS.
  • Counselor request phone number and a name (can be alias). This is to facilitate the confirmation result once so as to keep in contact with them for the WB arrangement and result.
  • With the confirmation results from SGH, the Counselor will get in touch with the client. Assistance and counseling will be provided to the client for the first six months of local treatment.
  • Explain to client about the referral letter for treatment and AfA will provide financial assistance of $200 for the initial test at CDC, NUH or SGH. If the client decide to get treatment locally, at this stage is where the client will no longer be anonymous but with the maintenance of confidentiality and privacy.
  • Counselor will introduce Client about support groups such as Project Hope and if interested their contact details will be passed to the support group coordinator.

Request for MOBILE ANONYMOUS TESTING & COUNSELLING SERVICE

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