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Targeting Southwest Philly HIV hot spot with mobile testing, community engagement
The 19143 has more HIV/AIDS cases than any other zip code in Philly. A new effort seeks to test every resident, to curb the "mini-epidemic."
Targeting Southwest Philly HIV hot spot with mobile testing, community engagement
In Philadelphia, a major risk factor for contracting HIV — along with all the known behavioral indicators, like unprotected casual sex and intravenous drug use — is the simple fact of living in a highly affected neighborhood. That's because Philadelphia, like other major cities across the country has "hot spots" where rates of infection are exponentially higher than the city's less-affected districts. Yet, public health experts have been trying (and to some degree failing) to combat the spread of HIV by focusing almost exclusively on changing behaviors. Now, Brown University professor and researcher Amy Nunn is partnering with local health-care providers and community activists to try a new tactic: "Do One Thing," a highly targeted effort to bring testing to the 19143 zip code in Southwest Philadelphia, which is disproportionately affected by the virus and where 89 percent of HIV/AIDS cases are among African Americans.
The project, which includes outreach through the clergy, block captains, local businesses, community groups and the federally qualified community health center The Health Annex, will bring a mobile-testing van into the zip code for block by block screenings. "Nothing on this scale has ever been attempted in the U.S," says Nunn. She says the "mini-epidemic" is exacerbated by poverty and by limited access to (and awareness of) rapid-testing facilities, since testing and treatment via antiretroviral drugs are key to stopping new infections from occurring. "It's not because people in these communities are engaged in any riskier behavior. It's just that there is more virus circulating in that community," she says. "It's unconscionable that we're 30 years into the AIDS epidemic and African Americans have eight times the likelihood of contracting HIV, when they don't engage in any riskier behaviors. this is a social-justice crisis and a public-health crisis, and we have to respond accordingly." (More after the jump.)
Philly HIV/AIDS cases by zip code, 2010
Nunn and her partners are hoping to do 5,000 tests this year — a 15-fold increase in testing in the zip code. In March, the Health Annex kicked off its portion of the campaign by switching over from risk-based HIV testing to offering routine testing to all patients age 13 and up. Since then, Do One Thing partners have been training medical students from around the city in peer counseling and equipped the mobile testing van, which had its inaugural run last week.
However, the most important aspect of the effort may be the community organizing aspect, Nunn says.
"When the gay community mobilized in the late '80s and '90s, that prompted sweeping policy changes and really ushered in an era of mobilization and even development of new drugs. We think that community mobilization has to be a critical component of this project: not just offering testing, but also stimulating community demand for it and really mobilizing the community around this issue."
By contrast, she says many people she's spoken with in Southwest Philly don't seem to be aware that the HIV crisis is still ongoing. Emily Nichols, director of the Health Annex at 61st and Woodland, says a recent survey of 500 local people found the majority don't believe they're at risk for HIV. And since the Health Annex has been offering routine testing, they've faced about a 50 percent decline rate. "The majority said they were recently tested, and the second-largest group said they had not expected an HIV test. We need to get them to where they're going to expect it."
San Diego launched a program like this last May and it is working VERY well in two target zip codes. Glad to see another city using the same technique to build a healthier community! Here's the website for the San Diego program: www.leadthewaySD.com— jpromero
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