Innovations in Testing and Care

The aim of the Martin Fisher Foundation is ZERO new HIV infections and in order to achieve this it is important that all HIV positive people know their status and can be treated. Treatment results in undetected levels of the HIV virus and therefore the virus can’t be passed on.

Some examples of innovation in testing undertaken by the Martin Fisher Foundation

 

  • Early adopters of opt out HIV testing in hospitals

 

  • Screening for Blood Borne Viruses in rough sleepers

A partnership between the Brighton-based HIV charity, The Martin Fisher Foundation and not for profit organisation EmERGE mHealth Ltd, saw  the launch of a hepatitis and HIV screening programme for temporarily housed rough sleepers in Brighton & Hove (B&H). Outreach workers from Brighton & Sussex University Hospitals NHS Trust (BSUH) and the Terrence Higgins Trust (THT), aided by St Mungo’s support workers and Brighton Housing Trust (BHT), offered screening and sexual health assessments to homeless individuals, many of whom have had difficulty accessing traditional services. This project was funded by Gilead Sciences.

Dr Gillian Dean, Trustee of the Martin Fisher Foundation and Consultant HIV Physician, said “the Covid-19 response gave us a once in a lifetime chance to reach out to this traditionally ‘hard-to-find’ group and offer them screening. The project supports the Brighton & Hove Towards Zero HIV initiative, whilst also working towards the national target eliminating hepatitis C”.

Marc Tweed, Centre Manager at Brighton THT said “At the heart of the project is working in partnership with a network of professionals in the city, drawing on their specialist knowledge and skills to ensure that what we are offering meets the complex and diverse needs of the people we want to engage with. It is vital during the COVID 19 pandemic that we don’t forget about other viruses which are still affecting people, we must continue to adapt and innovate testing services through developing fantastic new ideas such as this one so we can reach and support those who are most vulnerable in our communities”.

The project ran for 13 weeks and our fantastic outreach workers, Abby Smith-Hatton (BSUH) and Marek Coskry (THT), approached 97% of clients, with 72% (n=192) taking the tests. The main reasons for declining were people were ‘already aware of their status’ or had ‘low perceived risk’. 16% (31/192) tested positive for previous hepatitis C (antibody) with 13 of these having active infection (RNA positive). The project has also provided a re-engagement opportunity for known HIV patients who had partly disengaged from care. A few vulnerable clients were diagnosed with STIs and engaged with B&H Sexual Health & Contraception (SHAC) services.

For the 179 clients who didn’t have active infection, many expressed gratitude and relief to know they were ‘all clear’. Of the 13 clients with active Hepatitis C, many were surprised to learn that the infection is now completely curable by taking just one tablet a day for only 8-12 weeks, with very few side effects. Most have engaged with services and either decided to start treatment straight away or plan to start at some point in the future. Each patient needs a tailored engagement plan to succeed with the journey from testing through to completing the course. Engaging clients following diagnosis has been challenging but made easier with the wrap around care provided by the outreach workers, named St Mungo’s key-workers, the community hepatitis nurses and ARCH healthcare (primary care services). Moving forward we plan to continue this unique collaboration and continue offering BBV testing to rough sleepers in B&H through to Spring 2021.

  • Opt out HIV testing in General Practice Clinics

This is an exciting area of innovation in testing. The Martin Fisher Foundation has worked with local GP leaders to aim to offer free HIV tests to all patients attending their GP practice for bloods. All patients will be asked if they consent to have a HIV test at the same time they are having their bloods taken for another reasons – so no extra blood tests needed!

The Martin Fisher Foundation requires funding to get this project started.