Extreme Clinic Makeovers Would Increase HIV Testing

Public health clinics are cold, emotionally sterile places. As public institutions they provide services that allow anyone to get tested for STI's, including HIV. They mean well, but poor and dated execution of their messaging overshadows the potential excellence of their services.

I'm not implying that the hard working professionals who screen and test for STI's or file and compile public health information are lazy slops dredging through the 9 to 5. Public health work is the most lucrative of careers, not to mention the bureaucracy alone is enough to warrant medals.

But as any marketer worth their Beemer will tell you, the key to success is branding. Simple messages travel far when packaged effectively.

For the thousands of clinics in the States and around the world, packaging is a concern. Anyone can understand that STI's are pubic hazards that spread out of control if not contained. The problem is exactly how I termed it: Visitors enter clinics because they know something or someone has gone wrong. Once they arrive, the clinic does little other than treat them as hazards to the population—a wintery reality, but a chilly statement to someone who's misfortune or misstep finds them at a public clinic waiting to be counted in the day's statistics.

Most clinics bill themselves as welcoming places, but create environments that are as chilly as the term "public hazard."

Firstly, there's triage which starts with pulling a number and a consultation with a pubic health worker. No one's eager to Foursquare the STD clinic's location or the time they arrive. Clinics know this, so they often allow visitors to answer the dreaded "Why are you here?" without giving a name. This is great for anyone leery about how test results carry through health records. So, anonymous clients are issued a number or letter. From this point they are known as "Q" or "7" but none so glamorous as a James Bond movie.

The client then waits until their new name is called, often surrounded in close proximity by many strangers who also aren't in very social moods. As entertainment, many clinics loop short films and animations depicting scenarios where other, less hazardous, citizens say "no" to unprotected sex though a dynamic willpower that the clinic visitor obviously doesn't possess.

Anxious faces fidget on cell phones, others stare blankly at magazines. None comfortable. Why would they be? In a few minutes or a couple of weeks they may get news that will change their lives.

All the while, plentiful posters with safer sex messaging cover bland walls and actors rejoice their more noble choices. "Unlike me," they say, "you belong here." Constant streams of people flow in and out, serving as reminders that no person there is alone, yet everyone is so alone. One time at a clinic may be the last.

An estimated 240,000 Americans, including gay men, are unaware that they have HIV. Yet, public health officials seem baffled by the high incidence of people, namely gay men and MSM's, who either refuse to get tested or choose not to pick up their results. However, the stigma of having HIV is far worse than actually having it. In these cases, ignorance is bliss.

Sadly, with 50,000 new HIV infections each year (the U.S. accounts for over half), ignorance is the last thing we need to advocate. So, how do we get people tested?

There are a number of strategies from mobile units that target neighborhoods with high HIV rates to creative advertising in the reflection of target populations. But once the person gets to the testing service, the public clinic in my example here, they are met with the same stigma and callous environment that they're avoiding in the first place.

Companies like OraSure Technologies which markets and sells home rapid HIV testing kits, estimates the home HIV test market at $500 million retail. This is a telling indication of how many people are want to test in the privacy of their homes.

A federal advisory committee on Tuesday unanimously approved the over-the-counter sale of OraSure's home kit. If the recommendation accepted by the Food and Drug Administration, the units will hit drug stores soon.

Some, such as Phill Wilson, executive director of the Black AIDS Institute, as reported by Philly.com, believe that quick home testing is another weapon in the fight against low testing rates.

However, like the clinic, the quick test isn't an ultimate solution. What OraSure has done is market a new way to solve an old problem. I suggest public clinics do the same by repackaging the way they offer services.

Take a cue from reality home makeover show and develop creative renovation initiatives that encourage citizens to get tested often.

Clinics should tear down the posters and switch off the propaganda television. Give clients buzzers, like in restaurants, to alert them when their testers are ready. Greet them with empathy as adults who seek to be understood, not chastised. There's a reason why he or she made their choices. Part of prevention is understanding the method behind those choices.

The clinic, in essence, is a medical facility and they don't let you to forget it. But, who wants to visit a hospital just to see what's going on? People only go when they have to, and even then it takes prodding.

Change the atmosphere to encourage clients to open up about their situation, which gives insight into their behaviors. And for the ultimate question of funding, commission local businesses and artists to transform the space. Name the facility after the interior design house that donates it's time and materials. Encourage the many health advocacy organizations to set up camp inside and outside of the area. Invite clients to consider their health through creativity, without chastising them for mistakes undone.