IV. Testing

          After identifying and locating those at risk of infection, the first step to successfully prevent the spreading of the AIDS epidemic in the homosexual (and any other) community is to ensure that those at risk are tested for HIV.  Currently Pittsburgh has seven private HIV testing locations, with the Pittsburgh AIDS Task Force (http://www.patf.org) being “the only free, anonymous, community-based HIV testing in the region,” the only private location that offers testing every day of the week, and only one of two anonymous testing sites in Allegheny County (2).  The other testing locations are the Gay and Lesbian Community Center, a shelter for homeless women, Planned Parenthood of Western Pennsylvania, Adagio Health (a healthcare provider), a substance abuse clinic, and a gay bar.  Pittsburgh also has five public testing sites at the University of Pittsburgh, the Veterans Association Healthcare System, and various locations for the Allegheny County Health Department.  On the plus side, these twelve locations are well distributed throughout the city, with locations in the North Side, Downtown, Squirrel Hill, Oakland, and Wilkinsburg, making it easy for anyone living in the city to get there.

However, these locations certainly have their negatives.  For example, testing at Planned Parenthood and Adagio Health costs money, and testing at the shelter for homeless women and the substance abuse clinic is limited to individuals involved in their programs.  Also, the Veterans Association location only provides tests to veterans who can prove they served, which creates a difficult problem for homeless veterans with no way of proving their service.  Another problem is the fact that most of the testing locations are public or owned by the healthcare establishment, an institution that is often distrusted within the African American community, who have shown tendencies to expect racism, discrimination, and even illegal experimentation like that of the Tuskegee Syphilis Study in the US healthcare system (19).  One of the biggest problems with these current testing locations is that they generally cater to a homosexual clientele, a factor that would prevent ‘down low’ individuals from visiting them, as members of this group often consider themselves heterosexual, even if they are MSM (18).  In fact, while the University of Pittsburgh AIDS Center for Treatment is the second site in the County providing anonymous testing, these tests are solely available to homosexual or bisexual men.  Another problem with these testing sites is that while they all provide confidential testing, only the Pittsburgh AIDS Task Force and the Pitt AIDS Center for Treatment can legally offer anonymous HIV testing, which although not definitively linked with higher rates of testing, should still be offered as a possibility. 

To offer a service more accessible to the ‘down low’ and general homosexual community, the offering of HIV testing at gay bars has been shown to be quite effective and expanding this practice to other locations could be very beneficial (3).  Other possible locations could include the Pegasus Lounge, which was voted the most popular gay bar in Pittsburgh, located Downtown, and Club Pittsburgh, the city’s only bathhouse, also located Downtown (4).  Testing at these locations could prove to be very helpful in targeting homosexual men who are engaging in high risk activities in a location they feel comfortable in.  Also, offering testing on Saturday nights can allow for higher numbers of participants because the clubs are busy.  Interestingly enough, most testing sites in Pittsburgh offer rapid HIV testing, however the testing at the Pittsburgh Eagle Bar and Club doesn’t offer this service.  This may have something to do with the temporary nature of the testing site, but it could also be designed so that the target population won’t be deterred from getting tested by the chance of a night-ruining immediate positive result, a wise choice.  Because of its effectiveness, the cost for bathhouse-based testing (comparable to gay bar testing) is around $8,250 per new HIV case, which is cheaper than simple community-based testing, which costs around $11,481 (6).

Proceed to V. Needle Exchange

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