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Author Topic: your thoughts on this idea.. getting paid to get an HIV test  (Read 4448 times)

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Offline rstar

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Well this one came to me a while back and I just wanted to start a discussion on it or maybe get your opinions or input on the concept.

How would you feel if there was funding (let's say private, not government funded) that offered to pay high-risk individuals (risk and eligibility would be determined by a questionnaire) a divident of, say, $50 to take an HIV test to determine their HIV status.  Then, if they were found to be positive, they could be referred to treatment.

What would it hurt?  Millions and millions is spent on safe sex and prevention education, advertising, and other campaigns geared towards stopping new HIV infection and identifying existing infections, but the numbers aren't getting better.  A vast majority of this spread of infection, I'd say (speculation), is to blame on the fact that people who don't KNOW they're HIV+ are infecting others at alarming rates.

There are monetary benefits given for all sorts things, health related and not... for example, lower health  insurance costs for living healthier lifestyles, cash payouts for driving safely, tax incentives for all sorts of things, rebates/etc. for getting your prescriptions transferred.. just to name a few.

If nothing else, more people would get tested just to get the free money... but it wouldn't stop there.  As a result, people who didn't know they were infected, or might never have gotten tested in their life, if there had been no incentive (to some people, health and well being isn't enough of one), would get it done and know their status.

I mean, the idea came to me very randomly, but I thought it'd make an interesting topic of discussion.

Offline mecch

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Re: your thoughts on this idea.. getting paid to get an HIV test
« Reply #1 on: June 23, 2011, 08:09:29 AM »
Sure why not but what country? USA? "Referred to treatment" seems a big stretch.  First of all, all HIV+ don't need treatment.  Secondly, in the USA, who's gonna pay for all that?  You mean, referred to Health care?  Sure, that's better.  But who's gonna pay?
I think "referred to HIV educators" is the possible scenario.  Since you are interested in cutting the transmission rates.  What we want is people to know their status, and to know how to stop transmission. 

In a more perfect world, we want universal health care, but I guess you aren't talking about that.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline rstar

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Re: your thoughts on this idea.. getting paid to get an HIV test
« Reply #2 on: June 23, 2011, 08:51:52 AM »
i didn't ask who was going to pay, or expect that to be thrown out there off the bat, but it is a good point.  just think about all of the organizations and agencies out there that do have money to, for instance.. dispense prophylactics which enable people to practice safe sex.. or display advertising materials (print, radio, television, internet, whatever) with messages about STD prevention/testing/etc... what i am getting at is that there IS definitely money out there that is being spent on other areas of STD prevention/awareness (specifically HIV/AIDS) so it isn't like the money doesn't exist, it would just need to be shuffled around.  not like that is a new concept when it comes to funding stuff when there isn't money for it.

but anyway, "referred to treatment".. when it comes to HIV/AIDS, even if a person doesn't have health coverage there are government funded clinics all over the country providing care to even the most impoverished of people.  so, all i'm saying there is that true.. health care isn't something you can just snap your fingers and have access to in the USA.. trust me i know that, i dont even have health coverage myself.  but with things such as HIV/AIDS, you can get care for it without coverage

Offline mecch

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Re: your thoughts on this idea.. getting paid to get an HIV test
« Reply #3 on: June 23, 2011, 08:57:11 AM »
but with things such as HIV/AIDS, you can get care for it without coverage

You need to read more on this forum and in the news about the ADAP funding crisis.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline rstar

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Re: your thoughts on this idea.. getting paid to get an HIV test
« Reply #4 on: June 23, 2011, 09:09:15 AM »
no, i'm well aware of the crisis going on.. I was on our state's waiting list for quite a while until they used emergency funds.

anyway, i guess i knew this was going to turn into a flame war. 

Offline leatherman

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Re: your thoughts on this idea.. getting paid to get an HIV test
« Reply #5 on: June 23, 2011, 10:24:41 AM »
no, i'm well aware of the crisis going on.. I was on our state's waiting list for quite a while until they used emergency funds.

anyway, i guess i knew this was going to turn into a flame war. 
no it's not a flame war. Your idea is being practically considered and you're just not happy that the biggest stumbling block to overcome for implemention of your idea has been brought up. ;)

Your basic idea isn't that bad. People get paid money to donate blood and sperm, why not some spit for an HIV test. But don't diss anyone just because they are actually considering the practical application of implementing your idea - and find that funding (since you want to PAY the testees) would be one of the biggest hurdles to jump to put your idea into real world practice. ;)

There is no such thing as unlimited funds. Right now agencies are struggling to keep (and many are losing!) funding that has gone to prevention programs that have proven effective. (However your idea has not yet been proven effective.) So, in a time of cut budgets, there really is no money to shuffle around. And if there was more money, it needs to be shuffled around to treatment for people who we know are already positive and going without meds.

even hear the old adage, "follow the money"? that's why the object of money has been brought up concerning your idea. It would cost a great deal of money - the staff, a clinic, the tests, and the payment to the testees (LOL I said testes ;D). Even if  this testing/payment program was provided at an established clinic, it would still have the overhead of staffing costs, the costs of the actual tests, and the payment you proposed.

So in considering your idea, or any prevention idea for that matter, money is of prime consideration. I personally wish that everyone going into a hospital would be tested; but when some hospitals/clinics charge $500-$800 for an std/hiv testing panel - which may not be covered by someone's insurance policy - getting "everyone" tested takes on a whole different appearance when that idea is put into practice. No matter what the strategy proposed, financing is very important to consider.

Since currently many clinics/ASOs already provide FREE HIV testing - with no payment to the client - your proposal greatly increases the costs of what is currently being done. Not to mention the additional overhead costs that would be incurred when your payment idea would increase the amounts of people getting testing. The cost/benefits of finding those few infected individuals in a high risk area out of the crowd of HIV negative persons would probably be too high to be practical.

You have a very interesting idea; but with the state of the economy, I think financing would prohibit your idea from being put into practice, even if this idea would result in identifying more infected people.



by the way, congratulations for being off your state's waiting list and finally getting access to life-saving antiretrovirals ;D As I track and post the ADAP numbers here and have been advocating a lot to get ADAP fully funded in all the states, I'm always glad to hear when some people have made it off the waiting list - especially when they've finally gotten meds and not died to get off the list. :o However as of 6/17 there are still 8,404 fellow citizens in 13 states who are eligible financially and clinically for HAART and are living everyday with a ticking timebomb of a terminal illness and no access to medication because of a lack of funding.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline mecch

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Re: your thoughts on this idea.. getting paid to get an HIV test
« Reply #6 on: June 23, 2011, 10:36:12 AM »
Its not a flame war  :(
Just as leatherman says, its about who pays.  Would be cruel to encourage people to test who might need the 50 bucks then turnaround and say tough luck to the poor and uninsured.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Gio

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Re: your thoughts on this idea.. getting paid to get an HIV test
« Reply #7 on: June 23, 2011, 11:43:37 AM »
There is some merit to the idea..  The way I found out that i am POS was through a Gay Men's Health Study in GA.  If it wasnt for that I think i would of found out when i was at the hospital.  One thing i did not like was that I was not directed to any particular organization no follow through..  I was just simply told to contact my Healthcare provider.  With test like that the organization should definitely have a game plan ready to be placed into action.  There is a period were your in shock and denial.    You get soo overwhelmed that you need that individual to get you to a point when you are ready.. 

Offline mecch

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Re: your thoughts on this idea.. getting paid to get an HIV test
« Reply #8 on: June 24, 2011, 03:11:43 PM »
I was never a member of the "never test" camp so I can't relate to the rationale behind it. 
And I agree it would be especially cruel to the "never test" camp to test and just dump the news on someone and bye bye.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline leatherman

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Re: your thoughts on this idea.. getting paid to get an HIV test
« Reply #9 on: June 25, 2011, 05:59:47 PM »
I was part of a special National HIV Testing Day (6/27) event that my ASO held today*. While chatting with several members of the prevention/education dpt. the talk of incentives (like the idea of paying to take a test) came up, so I picked their brains about the subject and came back with a couple of points.

1) the amount of the incentive has to be enough to get people in to test, yet not enough to enable risk habits or "coerce" someone into testing.

At a previous testing event at a homeless shelter, rather than an incentive of cash (which the staff of the shelter believed would get "misspent" on drugs or alcohol), the ASO instead provided a bag of toiletries (bar soap, laundry soap, razors, shaving cream, toothbrush and toothpaste) in exchange for taking an HIV test.

At another event they provided $5 Walmart gift cards. This amount basically covered the travel/gas expense of coming to the event to get tested. A higher amount of incentive could get people to test, not because they wanted or needed to know their status, but as a way to gather money to pay off utility bills etc. A high amount given out in a poorer (and/or high risk area) could get people, unprepared for the results, to test out of desperation of hard economic times.

The staff has also used this incentive gift card idea when speaking to people who seem interested in testing as we are closing up a health fair exhibition, closing up the clinic for the day, or when speaking with people at events where we aren't doing testing as an incentive to get them back to the clinic during our testing times.

2) not only do the incentives need to be appropriate but they probably need to limited in scope.

depending on how much the event is advertised, the amount of incentives to be given out may need to be limited because of the space for the event or to not bankrupt an agency. For example, the $5 gift cards could be limited to 100 given out at an event (that's $500 in incentives, not to mention the paid staff hours and costs of the test). Advertising that the amount is limited to 100 incentives could help prevent 2000+ people from arriving and overwhelming a testing site and the staff delivering the tests. No one wants to have a riot on their hands when all they wanted to do was get a few people tested for HIV. LOL

3) Of course, there are also the issues to consider after the testing of aftercare counseling and treatment. As many problems as there are with the "test-n-treat" philosophy, just testing people and leaving them is inappropriate and doesn't really solve any of the problem of reducing the spread of HIV. People that test positive need to be directed towards doctors, ASOs, and agencies that can then help with counseling, health care/treatment.

*Though we passed out several hundred flyers throughout the south side of town (health clinics, barber and beauty shops, hardware stores, liquor stores, convenience stores etc were all very kind to post our flyers and hand out literature about our event) this past week and prepared for a large crowd, we only had a dozen people show up, with 6 getting tested. Thankfully there were no poz results.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

 


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