HIV self-test kit project hopes to break down barriers to sexual health care

A new pilot project hopes to help end HIV in Canada long-term by removing barriers to getting tested that several at-risk communities face, and it all starts with a tiny take-home kit now being distributed by community groups.

The I'm Ready research program kicked off earlier this month. Community groups received some of the project's 50,000 HIV self-test kits to distribute, with kits landing at seven Manitoba sites in The Pas, Brandon and Winnipeg. 

HIV self-test kits have been available to the public in the U.S. and U.K. for several years, but they were only legalized in Canada last fall thanks to research by Dr. Sean Rourke and others.

"There's reasons why they're not coming forward for care: obviously, stigma and all kinds of other barriers," said Rourke, program director of REACH Nexus and a scientist at the MAP centre for urban health solutions at St. Michael's Hospital in Toronto.

"We're now wanting to make sure that now that this test is approved, how do you get it to people in the most accessible, low-barrier ways?"

REACH Nexus is the organization behind the I'm Ready research program, which was funded by the Canadian Institutes of Health Research to help find innovative ways to get self-test kits to market, Rourke says.

Between the initiative's website and app, people can access tutorials on how to use the kit, find answers to frequently asked questions and where to access peer counselling and other supports in the event of a positive result.

The app also allows participants to provide input about their experience for research purposes and order kits.

Rourke says there are an estimated 8,000 Canadians — or 13 per cent of all cases according to Public Health Agency of Canada — who are HIV-positive and don't know it.

As a result, they aren't benefiting from the treatments widely available today that aren't only lifesaving but reduce a person's viral load to undetectable levels. That means they can no longer transmit the virus.

"There's a huge public health benefit, so if we want to reduce HIV in Canada, we have to reach those people who are undiagnosed [and] help them to get connected to care," Rourke said.

In theory, anyone can go to a walk-in clinic or their family doctor and request testing for HIV and other sexually transmitted infections. In reality, there are a range of things keeping some at-risk groups away.

"It's an unfortunate need that it may fill a gap in the short-term," said Mike Payne, executive director of Nine Circles in Winnipeg, one of the sites where people can now get kits.

There are about 1,300 diagnosed Manitobans living with HIV right now, he estimated.

Winnipeg's overdose rates have shot up during the pandemic, and Payne says injection use of crystal meth is another way HIV may be spread in communities that don't typically feel supported by conventional clinics and care centres.

Payne also says health-care professionals in the community sector are bracing for an uptick in a range of sexually transmitted infections, including HIV, due to decreased access to care during the pandemic, when the focus and resources shifted toward COVID-19.

That's led to people avoiding routine testing during the pandemic in some cases, Payne says. Nine Circles has already begun to see an increase in HIV-positive results through testing there.

"There's a large population of folks who already weren't accessing health care all that well, specifically Indigenous folks, people of colour, people from the LGBTQ community … because they have experiences of homophobia and racism and other types of experiences within traditional health-care services," he said.

"So all of those things combined … don't position us well. But it is a reason for us to figure out, what are all the ways that we can get resources out to people that are comfortable for them, for them to know their status so that we can then encourage them to help connect to the services that they need."

Payne says in addition to stopping by one of the community organizations to get up to three self-test kits, Manitobans can also order delivery — something of value to those who want to minimize their close contacts, or to those who live in remote and northern communities.

Participating partners in Manitoba:

Blake Garden Resource Centre

• Unit C-312 Blake St, Winnipeg, MB, R3E2Z4
• 204-792-8191
• Website

Gilbert Park Resource Centre

• 7-35 Gilbert Avenue, Winnipeg, MB, R2X0T4
• 204-982-4429
• Website

Nine Circles Community Health Centre

• 705 Broadway, Winnipeg, MB, R3G0X2
• 204-940-6000
• Website

NorWest on Alexander (NOA) Resource Centre

• 1880 Alexander Avenue, Winnipeg, MB, R2R0G7
• 204-940-2662
• Website

Sexuality Education Resource Centre – Brandon Office

• Unit B-345 10th St, Brandon, MB, R7A4E9
• 204-727-0417
• Website

The John Howard Society of Brandon

• 153 8th St, Brandon, MB, R7A3W9
• 204-727-1696
• Website

The Pas Committee for Women in Crisis

• Box 3779, The Pas, MB, R9A1S4
• 204-623-7427
• Website