Background Past Present Future

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2 Background Past Present Future

3 Background Early testing helps to prevent transmission and lowers the risk of severe health complications Programatic objective: To increase the percentage of HIV + persons who know they are infected and link them to care

4 % % Prague Bratislava Barcelona Bucharest Ljubljana Verona MSM with OF HIV+ test result MSM unaware of their HIV+ status

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6 HIV DIAGNOSIS MONITORING IN CATALONIA activity coverage adequacy % late diagnosis % recent infections

7 23 years of harmonized information 23 % of all new HIV diagnosis

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9 Scaling-up HIV testing and counseling as an essential component of efforts to achieve universal access to HIV prevention, treatment, care and support in the WHO EURO Region (WHO/Euro/working paper): 2.- Expanded HTC must be tailored to different settings, populations, and client needs. 4.- Efforts to increase access to and uptake of HTC must meet the needs of most-at-risk and vulnerable populations and expand beyond clinical settings 5.- Rapid HIV test should be used, where appropiate, to support efforts to increase access to and uptake of HTC 10.- Efforts to expand access to HTC must be carefully monitored and evaluated HIV testing in Europe: from policy to effectiveness (ICRH, Ghent University/commissioned by the ECDC) there is a need for additional information to map HIV testing policies and guidelines, and to identify practices and barriers with regard to HIV testing and counseling, emphasising the access to HIV testing; the provision of HIV testing services and the perceptions with regard to HIV testing and counseling

10 WHAT I S GOING ON IN EUROPE ON CBVCT SERVICES? HOW COULD WE MEASURE IT? WHAT INFORMATION IS ACTUALLY BEING COLLECTED? HOW COULD WE IMPROVE THE PERFORMANCE OF CBVCT SERVICES?

11 TERMINOLOGY Voluntary Counselling and Testing (VCT) Client iniciated HIV Testing and Counselling Provider iniciated HIV Testing and Counselling opt. out opt. in Health care setting Non health care setting Community based Outreach Point of care

12 COBATEST definition: "CBVCT is any program or service that offers HIV counselling and testing on a voluntary basis outside the formal health facilities and that has been designed to target specific groups of the population most at risk and is clearly adapted for and accessible to those communities. Moreover, these services should ensure the active participation of the community with the involvement of community representatives either in planning or implementing HIV testing interventions and estrategies" Epidemiological concept Epidemiological concept Community concept Community concept

13 Diagnosis of situation

14 COBATEST network 45 CBVCTs of 19 European countries (Germany, Denmark, Chez Republic, Poland, France, Slovenia, Belgium, Romania, Portugal, Lithuania, Latvia, UK, Hungary, Ukraine, Austria, Greece, Switzerland, Italy and Spain) M&A indicators STANDARDIZED DATA COLLECTION FORMS WEB BASED APPS FOR DATA COLLECTION

15 WP 7 WP 4 T1

16 WP5 N : MSM WP8 Patterns, barriers and determinant s of use 16

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18 StandardizeCOBATEST d data network collections instruments M&A and tools indicators M&A data analysis Patterns, barriers and determinant s of use Services implementation and evaluation guides Operational definition Quality assurance Diagnosis of situation Data integrations with national surveillance systems

19 Community Policy makers Public health and academia

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21 Validation and analysis of HIV testing data in the community setting COBATEST NETWORK

22 Clinic-based Evaluation of Point-Of-Care Tests

23 WP6- Objectives 1.To identify indicators and adapt existing data collection/m&e tools (COBATEST) to assess the impact of the European Testing Week (ETW) related to HIV, viral hepatitis and STIs testing and linkage to care. WP6- Objectives 2.To describe methods and drivers/barriers for integration of testing and linkage to care data on HIV, sexually transmitted infections (STIs) and viral hepatitis from European healthcare settings and community based voluntary counselling and testing (CBVCT) services. 3.To support the integration of testing and linkage to care data from CBVCT services into national surveillance and monitoring and evaluation (M&E) systems on HIV, STIs and hepatitis C virus.

24 WP6- Objectives Spain Slovenia Slovakia Estonia Serbia Poland PILOT COUNTRIES

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26 1est Anual Meeting Improved Network App Improved dissemination

27 Strengths Weaknesses COBATEST network SWOT analysis 1. Standardized data collection forms, web based tool and core group indicators already in place. 2. Harmonized data is feasible. 1. Lack of resources to encourage the participation of the CBVCTs members of the network. 3. Experience, collaboration. 4. Different complementary projects on going. 2. Not all CBVCTs are able to use the developed web based data entry tool: different ways of submitting the collected data 3. Representativeness and heterogeneity of services 4. No information on the quality of the data 5. Low visibility Opportunities 1. Interest of ECDC in the potential use of data collected in CBVCTs for formal surveillance systems. 2. Generate strategic information, as recently has stated the Consolidated Strategic Information Guidelines published recently by WHO. 3. Provide important information for the continuum of prevention, care, treatment and support, improving some information gaps at the level of prevention and HIV testing and also at the level of linkage to care. Threats 1. Duplicity with other initiatives and networks 2. Too many non coordinated request to centers. 3. Lack of retention of the participating CBVCT services 4. To implement complementary operational projects (WHO POC validation cohort, medicalization survey, ) 5. TO STRENGHT COLLABORATION ACROSS SECTORS AND ORGANIZATIONS. AVOID DUPLICATION. GAIN EFFICIENCY. 6. More opportunities for fund raising SWOP

28 Strategic objectives : Assure its sustainability Improve the Network Governance Create strategic alliances Include new sites (eastern European countries) Continue its applicability: Contribute to improve the programs and services Contribute to national and international indicators. Improve visibility and dissemination...

29 Call for proposals N EACEA-33/2017: Operating grants - Structural support for European think tanks and for civil society organisations at European level

30 Community testing COBATEST network Monitorin g and Evaluation Capacity biulding Dissemination Discussio n Forum CEEISCAT? AAE AAE, Objectives: To improve the capacity of CBVCT sites to perform quality HIV testing and collecting good data. To help new CBVCT sites to perform quality HIV testing and collecting good data.... Objectives: To distribute information on COBATEST network across AIDS Action Europe members To disseminate the results of the M&E of the COBATEST network.... CEESICAT,? Objectives: To improve the standardized questionnaires and procedures for M&E of CBVCT services testing activity. To evaluate the potential impact of CBVCT services in the improvement of HIV early diagnosis and linkage to care. Objectives: To create a Forum in which the members of the COBATEST network can discuss about the different practices and can exchange best practices....

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32 New challenges

33 Can/want the COBATEST Network continue to be useful to ito its members and stakeholders and eventually to mprove the cascade of services across Europe? How?

34 Acknowledgements We are grateful to all colleagues from the CBVCT centres participating in the COBATEST network for their collaboration in the network : AIDS Fondet* (Denmark) Fondazione LILA Milano* (Italy) Demetra* (Lithuania) Algarabía (Spain)* AVACOS* PRAKSIS* CAS Gibraltar* OMSIDA* (Spain) StopSida* (Spain) Àmbit Prevenció* (Spain) Gais Positius*(Spain) SAPS-Creu Roja* (Spain) Centre Jove d Anticoncepció i Sexualitat* (CJAS) (Spain) Creu Roja Tarragona* (Spain), Actuavallès* (Spain) ACASC* (Spain) Associació Antisida de Lleida* (Spain) Assexora Tgn* (Spain) ACCAS* (Spain) Baltic HIV Association* (Latvia) ACAS Girona* (Spain) Asociación SILOÉ* (Spain) Associació Lambda* (Spain) Centro Social Polivalente Mujer Gades* (Spain) IEMEKAIE*(Spain) Gay-alliance (Ukraina) *BCN-Checkpoint is not a COBATEST member but has contributed with data Asociación Concordia*(Spain) Cruz Roja Córdoba (Spain) Asociación ADHARA(Spain) Proyecto Hombre (Spain) Concordia Marbella (Spain) AIDS-Hilfe NRW e.v (Germany) ARAS-AsociataRomana Anti-SIDA (Romania) Checkpoint LX (Portugal) Association AIDES (France) Legebitra (Slovenia) Czech AIDS Help Societ (Chez Republic) Association Prevent (Serbia) Positive Voice (Greece) AIDS Hilfe Wien (Austria) CBVCT network Poland LASS (UK) Le Kioske (France) Anonymous AIDS Association Switzerland Checkpoints (Hungary) ISKORAK(Croatia)

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36 thanks

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