The primary objective of the point of care (POC) testing program is to promote access to testing for members of Ontario’s priority populations. Program sites are encouraged to tailor their testing services to the needs of local populations and are often located in proximity to specific priority population. However, sites are also encouraged to collaborate with local community-based agencies to extend testing services beyond their physical site and provide outreach testing.
Maintaining quality assurance standards during outreach testing must be a priority.
Outreach testing may happen:
- at community events appealing to members of specific populations (LGBTQ Pride events, Pow Wows, ethno-specific events)
- at other relevant community services (AIDS Service Organizations, emergency shelters, harm reduction sites)
- as part of multi-faceted programming offered by another service agency (ethno-specific agencies)
When collaborating with another community agency to deliver testing, it is important that both partners are clear about their responsibilities to clients. Whenever possible, memorandums of understanding should be signed between the partners, specifying how:
- the community agency will promote the service and refer people for testing
- the confidentiality of clients will be protected
- private space will be provided for counselling and testing
- biohazardous waste will be disposed of
- clients will receive follow-up care
Follow-up care is particularly vital. While the testing site is primarily responsible for supporting the client through their initial reaction, and linking them to follow-up care, partners may often need to discuss the response to a reactive test. This is particularly important for partnerships with services, where the client may stay, after the testing agency has left. What supports will they need beyond the initial relaying of this information? How will their confidentiality be protect if they are distraught?
In some circumstances, such as testing at a shelter or harm reduction venue, it may be appropriate for case managers from the host agency to take leadership in the client’s ongoing care and support. However, in most circumstances it will be important for personnel from the testing venue to have appointment cards and other materials available, and to make follow-up appointments with clients to receive confirmatory results and further support.
- Could follow-up appointments happen at the outreach venue?
- Is it possible to arrange linkage to HIV care from the outreach venue?
- Where could follow-up medical care (HIV care, PrEP prescribing) be accessed that would be convenient for clients at this venue?
Don’t forget the needs of clients with non-reactive (negative) tests:
- Does the community partner offer services that might be useful to clients (support groups, mental health of addictions care, risk reduction counselling)? How might these be integrated into the pre- and post-test counselling?
- What other resources are available in close proximity to the outreach venue that might be useful? Are they accepting new clients?
If you are working to establish a memorandum of understanding with another agency, contact HIV and Hepatitis C program staff. They can provide a sample of a past agreement.
At community events, the testing site will typically be responsible for all aspects of the testing process. Your staff will need to bring everything required for testing, including some sort of private space for the testing itself (a booth or testing van.) Outreach testing staff should be experienced. The Ministry has established a benchmark for staff of having performed and analyzed at least 25 tests, before performing testing in this role. Outreach testing teams should include staff members capable of collecting blood samples for standard testing (following a reactive test, or during the window period.)