Synergism: AIDS Service Organization and State Health Department Link Resources to Meet STD Screening and Treatment Needs of Men Who Have Sex with Men (MSM)

Background: Arab Community Center for Economic and Social Services (ACCESS), has been funded by the Michigan Department of Community Health (MDCH) to provide HIV prevention services since 1993.  In 2010, ACCESS provided HIV testing to 238 individuals:  95% male, 67% Arab-Chaldean, 90% MSM; yielding 1.26% new positives.  In May, 2011 ACCESS staff approached the MDCH STD program, requesting assistance to integrate chlamydia (CT) and gonorrhea (GC) screening into their 2011 National Test Day Activities.  MDCH agreed:  providing collection kits, laboratory services, and medications for those testing positive.  Additionally, because the MDCH Laboratory had, in 2010, validated rectal and pharyngeal swab specimens for GC/CT testing, this service was also offered.

Objectives: To increase access to GC/CT screening among high risk MSM.

Methods: From June – September, 2011, in conjunction with HIV testing, ACCESS collected 227 GC/CT specimens from 154 unique individuals:  121 urine and 106 pharyngeal samples.  Clients were engaged at ten sites:  3 AIDS Service Organizations (ASO), 1 LGBT residential site, 3 bars, 1 transgender health fair, a bathhouse, and ACCESS’s main site. Client’s testing positive were referred to the ACCESS medical clinic for treatment; partner interviews were conducted, and notifications were made by ACCESS staff. 

Results: Positivity was highest for pharyngeal GC, at 8.5%.  Comparatively, GC positivity across Michigan’s public sites in 2010 was 3.5%. Positivity for GC and CT in urine was surprisingly low at 1.9 and 2.5% respectively. 

Conclusions: Integrating GC/CT screening with community-based HIV testing identified significant undiagnosed infection.  Clients were pleased to have access to GC/CT screening outside of their doctor’s office or health department.   

Implications for Programs, Policy, and Research: ASOs are trusted providers for the MSM community.  Rising rates of syphilis/HIV co-infection, and the high number of GC cases identified in this project, call for strengthening partnerships between public health and ASOs to increase disease intervention for high risk populations.