ASHM Report Back
Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
STI Screening in Cape York
Presenter – Joanne Leamy
Joanne led an enthusiastic presentation about the implementation of a large scale screening program in Far North QLD which adopted a peer education model to encourage STI and BBV screening among young people.
The scale of the project appeared somewhat daunting at the start. Fortunately, with much energy, and a strategy which put local communities at the centre, a significant improvement in testing rates has been achieved. Aspects of the project included:
- Screening in 10 remote communities and 2 towns in Far North QLD, targeted at young people.
- Traditional owner groups were included in consultations.
- Adequate staffing and ongoing staff training gave the project a real chance of success.
- Peers were recruited with the help of local employment agencies and given basic STI training. They received wages for their work. All peers were residents in the communities.
- Focus on workplace culture. It was acknowledged that working as a peer was not always easy. Support for peers was built in.
- An understanding of attrition. Young people may change priorities, and new peers may need to be recruited.
- Appropriate ‘branding’ of the screening drive in order to have cultural integrity.
- Incentives, e.g. daily prizes such as footy jumpers.
- Well planned outreach with adequate equipment.
- Continuous quality improvement was included. While the reaction to feedback by clinilinic staff was not always initially enthusiastic, it has been an important factor in developing the program.
The program led to a clear increase in screening rates across the area, rising from 24% in 2013 to 53% in 2017. Interestingly, syphilis rates were not found to be as high as expected (10%). As an example of resources required, at one of the sites which had a target population of 130 to 170 15-29 year olds, 7 staff members were present for 4 days of testing.
Joanne acknowledged that without the peer workers providing targeted messages, hope, and support, the project was unlikely to have been as successful. An example of their contribution included being able to bring local language to the testing setting. The presentation demonstrated that improved access can be achieved with a lot of energy and the right mix of resources.