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A Deep Dive into the Dean Street Express Clinic Model for Quick Anonymous STI Self-testing

OCT 18, 2016 | LORRAINE L. JANECZKO, MPH
People who would like to receive emergency contraception, a 28-day regimen of PEP to prevent HIV infection after risky sex, or be seen for genital blisters or penile discharge, or if they have had sex with someone with gonorrhea, chlamydia, syphilis, or LGV, can make an appointment to see a health care professional, usually on the same day, at the free sexual health and HIV clinic down the street at 56 Dean Street (www.dean.st).  
 
"At least 92% of people are treated within a week, whereas before the express, only 18% would be treated within a week. This reduces the community infectious time, which is a key goal," Dr. McCormack said.
 
Public Health England recommends that gay men should have routine tests every three months if they regularly have unprotected sex with new partners; and if they don't, they should be tested for HIV at least once a year.
 
"There is a high burden of STI's in HIV-positive population," Dr. McCormack said. "For HIV, we see people every six months."
 
Several websites help Dean Street's clients learn and take action:
  • The 56 Dean Street clinic coordinates messages with PrEPster (www.prepster.info), whose mission is to promote PrEP access. "Being at risk for HIV is a period you go through. PrEP is not something you take for life, unlike HIV treatment. And we need to get that message across," Dr. McCormack said. 
  • They also direct people to I Want PrEP Now (www.iwantprepnow.co.uk ) to buy generic PrEP that the staff monitors for quality from online pharmacies in other countries, which is much less expensive than buying through the National Health Service (£40 vs £400 per month). 
  • Gay men living in Greater London can receive at-home finger-prick HIV test kits by mail through Dean Street at Home (http://www.deanstreetathome.com/) and receive their results by text or phone call. Men who test positive are referred to 56 Dean Street for help.  
  • The Dean Street Wellbeing Programme (www.community.dean.st) includes art exhibits, movies, community discussions, performance art and other events, and talk therapy and support groups at 56 Dean Street and other venues. 
  • The Dean Street Express Clinic uses social media and Facebook (https://www.facebook.com/deanstexpress) to share timely messages about sexual health. "A video of Prince Harry's fingerprick HIV test was viewed by 2.8 million people on Facebook and picked up by The Sun newspaper, which has very high readership," Dr. McCormick noted. 
"How do you change your clinic?" Dr. McCormack asked the audience. "You need to create standards for the staff, especially with your business manager. Let them all own the change. Once you have the plan your staff is happy, check with your service users. Are clients happy to receive your services by text? Is it private enough? Harness technology, even if it feels strange."
 


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