Partner organisations

Using incentives to increase HIV testing: a case study from Wakefield

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Wakefield view from The Sandal Castle. The towers of The Wakefield Cathedral and The Town Hall are visible.

An innovative project in Wakefield, West Yorkshire has successfully increased testing rates in certain vulnerable populations by providing a £5 food voucher as an incentive – and key to the work was our partner, BHA for Equality working in collaboration with Turning Point.

In early 2023, public health officials at Wakefield Council identified that a new case of HIV was linked to a cluster of previous cases from 2021 among people who inject drugs (PWID) and those connected to homeless accommodation. It was clear that swift action was needed to prevent further transmissions.

Tackling HIV in vulnerable communities

PWID and individuals linked to homelessness often face multiple barriers to accessing healthcare, from stigma and misinformation to logistical challenges in navigating complex services.

That’s where commissioned services like BHA for Equality’s HIV Prevention and Support Service and Turning Point’s Drug and Alcohol Service come in. Along with Wakefield Council and UK Health Security Agency (UKHSA), they embarked on a multi-agency Incident Management Team (IMT) response to contain the cluster.

Incentivising HIV testing

To reach PWID and individuals in homeless accommodation, BHA Wakefield and Turning Point undertook extensive outreach activities. The primary focus was to raise awareness of HIV risks and offer point-of-care testing (POCT) for both HIV and syphilis, making testing both accessible and quick. What made this scheme stand out was a small but highly targeted intervention – an incentive program in the form of £5 food vouchers for individuals who agreed to take a test.

The rationale? Similar incentives had proven effective in boosting Hepatitis C testing uptake among PWID, and the hope was to replicate that success. These vouchers, redeemable for hot and cold food, were simple, but they addressed a basic need, providing a practical and immediate benefit.

Navigating ethical considerations

Offering an incentive to test can bring up extra ethical questions. The team in Wakefield were following examples from across the country, where incentive vouchers have been introduced for various behaviour changes when uptake is low. The team also kept track of whether any concerns or questions were raised by people not in the target group about why they weren’t receiving a voucher. During the pilot, no concerns of this nature were raised and Wakefield’s public health team continue to monitor the scheme, including outcomes and any challenges.

A dramatic uptake in testing

BHA Wakefield saw a 70% increase in POCT from the previous year, with 166 tests conducted over the 2023-24 period. More than half of these tests (51%) were linked directly to the voucher incentive scheme. There was one reactive HIV test and one reactive syphilis test linked to the scheme – with the person who got the reactive HIV result saying they only took the test because of the voucher.

The scheme didn’t just increase testing rates: it also helped break down common misconceptions around HIV. Comments like, “I thought you could only get it through sex,” and “I thought a test would be ages, but it’s really quick, it’s good to know!” highlight the critical need for ongoing education.

Lessons learned: What makes this scheme a success?

So, what can others in the HIV sector take away from this? Several key factors contributed to the success of Wakefield’s HIV testing incentive scheme:

Targeted approach: By focusing on a specific, high-risk group (PWID and homeless individuals), the scheme was able to channel resources where they were most needed.

Collaboration and partnerships: The collaboration between BHA for Equality, Turning Point, Wakefield Council and UKHSA was crucial. Each organisation brought its own expertise and networks, creating a comprehensive support system, responsive to the needs of the community.

Meaningful incentives: The £5 vouchers addressed an immediate need and resonated with the target population. Sometimes, simple incentives are all that’s needed to bridge the gap between intention and action.

Education and awareness: Outreach activities didn’t just focus on testing but also on education. Misconceptions about HIV transmission were prevalent, and this effort helped correct those while promoting testing as quick and accessible.

Building on success

Thanks to its success, the HIV testing incentive scheme in Wakefield secured additional funding for another year. The next challenge will be to assess its long-term sustainability and effectiveness, but for now, it’s clear that this innovative pilot has had a meaningful impact.

As we continue to face complex public health challenges, schemes like this remind us that even modest interventions, when thoughtfully implemented, can lead to significant results.

Sexual Health Week 2020

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Get your RSE in gear, Sexual Health Week 2020

The theme of this year’s Sexual Health Week is ‘Get your RSE in gear’, focusing on the introduction by the Department of Education of compulsory Relationships Education for primary pupils and Relationships and Sex Education (RSE) for secondary pupils this month in England.

Despite the impact the school curriculum has faced since March 2020 due to COVID-19, schools are being encouraged to begin teaching RSE. The subject is now compulsory, with schools who are facing challenging circumstances being advised to begin lessons by at least the start of the summer term 2021.

The implementation of compulsory RSE provides an opportunity to provide young people with the tools and skills they need to have good sexual health, and enable them to make informed decisions which impact their wellbeing. It will also provide young people with the education they need to learn about HIV and sexually transmitted infections (STIs).

What support do teachers need?

– Dave Grimmett, Head of PHSEE, Highgate Wood School

‘RSE is an important part of every student’s education which should not be underestimated. RSE empowers students to make informed life choices in situations which may affect their mental or physical health, RSE also holds the power to reduce the negative consequences of these decisions in the future.

‘RSE is often thought of as being focussed on romantic and/or sexual relationships. However, it also empowers students to become better citizens by encouraging them to value or at least appreciate the differences of others’ states of being, experiences, choices and beliefs. Whether this relates to gender, sexuality, culture or religious custom it inspires students to reflect on their own actions and how this may positively or negatively impact on someone else. In other words we are teaching students to be kind in their adult relationships, a trait which we try to instil at a young age in friendships but don’t always discuss as they become older.

‘My school highly welcomed RSE becoming compulsory as it has provided us with a greater understanding of what education young people need rather than what areas we think we should cover. It was validating as I felt our school had already delivered key areas of RSE, but it was obvious there were subjects we still needed to tackle.

‘As we create and update our curriculum, it is the perfect time to be innovative in what is taught and the way it is taught. This can be daunting for schools and colleagues who are new to teaching the content or have limited experience of teaching RSE. It may also be difficult for some schools to know how to adapt to the change, and to create enough time and space for RSE to be taught effectively, although this is important.’

Teachers can be supported with practical information from experienced health professionals and Voluntary, Community and Social Enterprise (VCSE) partners including:

  • The shared experiences of how to approach sensitive issues in group settings.
  • Examples of group activities that deliver health promotion work effectively that teachers could adapt to deliver RSE.
  • Resources such as videos or stories that communicate with young people clearly and could be used as a platform for further discussion and learning.
  • Key contacts in your organisations who can liaise with RSE leads in local schools and pass on relevant information and messages across local authorities.
  • Willing colleagues visiting schools or engaging via video conferencing to speak with RSE teachers and other key groups such as students school councils to answer questions they may have or to provide advice.
  • As the experts in sexual health, provide particular messages or local campaigns you want teachers to share with young people in your area.

While teachers and educational professionals are updating their curriculums and ensuring the professional development of RSE leads and their peers includes training on RSE, now is the best time to embed good practice and creatively share ideas and experiences.

Sexual health and HIV prevention ambitions

The Government has made clear commitments to establishing a national sexual health strategy to tackle increasing rates of STIs, and to reducing new HIV transmissions to zero by 2030.

The introduction of compulsory RSE adds vital support to these initiatives achieving their targets. Not only does RSE educate current and future generations of young people, but it also increases the volume of professionals working within the systems that can nurture good sexual health.

Health professionals working in sexual health and HIV, including those from VCSE organisations, commissioners and public health experts, clinicians and researchers, must support teachers as they navigate the new curriculum.

Educational professionals can provide vital expertise and pathways to reaching young people, who are some of the most disproportionately affected populations by high rates of STIs.

‘Get your RSE in gear’ is a perfect call to action to encourage experts in sexual health and HIV to think about how they evaluate the support they provide to educational professionals, and to motivate teachers to deliver good quality and engaging RSE in their classrooms.

Manchester launches new HIV campaign

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HIV: Let's sort this together.

The PaSH Partnership (BHA for Equality, George House Trust, and LGBT Foundation) have launched a new campaign which aims to end new cases of HIV in Greater Manchester.

Launched at the HIV Commission Hearing Session on 13 February 2020, the HIV: Let’s sort this together campaign is part of the first phase towards Greater Manchester’s ambition of ending all new cases of HIV within a generation by reducing transmissions, late HIV diagnoses, and eventually new diagnoses of HIV. This is an important part of the Greater Manchester Population Health Plan for residents to have the best start in life, and to live and age well.

The campaign

The campaign motivates residents of Greater Manchester to take charge of their sexual health and plan a safer, more enjoyable sex life in a number of ways:

  • TEST: Encourage residents to test regularly for HIV by providing information on how and where to test.
  • MANAGE: Advise those who test positive for HIV how to manage their HIV treatment and receive the support they need to reach undetectable and, therefore, untransmittable viral levels (U=U).
  • PREVENT: Inform and encourage methods such as PEP, PrEP, and condoms and lube.

The campaign is promoted via:

  • social media and digital advertising
  • radio and out-of-home advertising
  • the Sort HIV website
  • merchandise for community events
  • PR

Get involved

Community leaders, faith leaders, GPs, sexual health clinics and other stakeholders are invited to take part by:

  • Using promotional materials such as print-ready posters and flyers, waiting room screens and digital assets, including email footers, website banners and desktop wallpaper – access via Dropbox.
  • Sharing the campaign on your social media channels and through internal communications.
  • Telling service users and community members about SortHIV.org.uk, where they can access information about HIV and prevention as well as links to order home testing kits.
  • Using the hashtag #SortHIV to talk about the campaign on social media.