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Overcoming Obstacles to Testing (OOTT)

In 2014 NeLP started the Overcoming Obstacles to Testing (OOTT) program to identify and address obstacles to testing, promote targeted testing for and early diagnosis of HIV, and, most importantly, enable NeLP to serve as a regionally recognised monitor of testing rates in NeLP countries.

Within it we put a strong accent on cooperation and joint approaches to testing in order to get the best results, and developing cooperation between all levels of stakeholders. We encourage this cooperation on all levels, but when it comes to testing strategies, joining the civil society with healthcare institutions brings a lot of new ideas to the table, availability to the communities, linkage to care, support and additional prevention strategies.

Our goal for 2014 was to perform adequate comprehensive assessments of the current situation regarding HIV testing in the NeLP countries, but also to fundraise, organize, coordinate and implement activities on regional and national levels.

In 2014 we had a clear demonstration that such an approach works, and the groups that were formed around ETW remain a capacity to be used for the next year, but also beyond this week.

Key obstacles to testing

Crosscutting obstacles impacting all elements of society:

  • Cultural, religious and local traditional values - so enriching for some - yet they encourage authoritarianism, sexism, homophobia, resulting in feelings of powerlessness, cynicism and fear
  • in the general population
  • Low prevalence inhibits effective response
  • Low perception of risk from HIV and subsequently low response
  • Self-limiting expectations, amongst key stakeholders inside the government and in the general population, which inhibit effective response
  • Cultural attitudes that favour treatment over prevention in health care in general
  • Stigma and self-stigma related to HIV, and the discrimination and fears they generate
  • General lack of knowledge about HIV, the life-saving benefits of HIV testing and ARV
  • treatment, etc
  • Lack of coordination and communication amongst relevant stakeholders
  • Limited accessibility of easily to access testing sites and testing services
  • Non-existent or deficient laws, national plans and guidelines for HIV testing
  • Lack of targeted response, and low or non-existent inclusion of MARPs in testing
  • Lack of funding allocated for HIV testing and HIV-related activities and finally, and perhaps most important,
  • Prolonged economic challenges confounded by the World leading to growing inequality, joblessness and migration

Key solutions proposed

Proposed solutions to impact all elements of society – policy and decision making at all levels, healthcare delivery and civil society:

  • Demonstrate and encourage cooperation and information sharing amongst all key stakeholders including people living with HIV or at risk of HIV, healthcare workers, community testing providers and local and national decision makers
  • Advocate for accurate information about HIV treatment and care  HIV is preventable and
  • treatable
  • Advocate for accurate information on the benefits of HIV testing and early detection
  • Advocate for easy-to-access community HIV testing sites
  • Engage with key HIV stakeholders and opinion makers to ensure they understand and communicate accurate HIV and testing realities
  • Challenge stigma and support people living with HIV or at risk of HIV
  • Challenge harmful gossip and cynicism
  • Share information locally and regionally on the current situation and best practices from the region
  • Promote international activities like European HIV Testing Week on the local and regional level
  • Whenever possible, develop local and national testing task forces, to coordinate testing activities, that involve a wide spectrum of key stakeholders including people living with HIV, and provide linkage through NeLP’s OOTT project

Done so far

Our goal for 2014 was to establish an ongoing NeLP prevention and testing group which would scope subsequent project activities through the year, perform adequate comprehensive assessments of the current situation regarding HIV testing in the NeLP countries, but also to fundraise, organize, coordinate and implement activities on regional and national levels. The prevention and testing group would also communicate between countries and provide support when needed.

The Sarajevo meeting helped us form the NeLP group, and until now to form 10 local national task forces in member countries of NeLP. We have noticed a measurable increase of activities in NeLP countries, particularly those with local task forces in the preparation activities for the upcoming ETW 2014.

Future goals

This project is envisaged to contribute to keeping the low prevalence in the NeLP countries actually low, through higher testing rates and increased awareness of the benefits of HIV testing.

Although we expect increased testing to result with more new diagnoses, it would also minimize late presentation, increase level of access to treatment, reduce unnecessary infections, improve public health in these countries, and finally reduce healthcare costs by eliminating the superfluous costs of managing late presentations.

Goals for 2015/2016:

  • Perform a detailed analyses about HIV and HepC testing in NeLP countries
  • Organise a capacity building meeting on advocating for improved HIV and HepC testing
  • Continue the work of the NeLP prevention and testing group, and to support development, growth and impact of local task forces.
  • Support member countries in joint activities and participation in European HIV testing week 2015