October 2016—Le Minh Thanh is the leader of G-Link, a community-based organization and social enterprise supporting men who have sex with men (MSM) and transgender women (TGW) in Ho Chi Minh City. Thanh is also one of Vietnam’s first HIV lay testing providers. In this role, he delivers HIV testing services directly to MSM and TG clients using a rapid HIV finger prick, a diagnostic that can be administered easily and quickly.

When his clients receive a reactive result on the rapid test, Thanh counsels them to obtain confirmatory testing and—if confirmed as HIV-positive—early treatment.

G-link’s new lay testing services are possible because of a USAID-funded initiative, Healthy Markets, a recently introduced community-based program designed to fill gaps in testing among key populations at high risk of HIV in Vietnam. The community friendly approach aims to bring testing services closer to those who need them most—key populations such as MSM and TGW, people who inject drugs, and female sex workers and their clients. The program, which was launched in October 2015, is implemented by PATH, a global health organization.

“Community-based testing is so convenient and friendly. I can be tested at any time, any place, and I feel very comfortable doing so. The test is also fast—I don’t have to wait long for the results,” said one of G-Link’s MSM clients.

Lay testers in urban areas provide services either at the offices of community-based organizations or at outreach sites such as coffee shops, parks and saunas. In mountainous rural areas, lay testers conduct testing at their own house or at the client’s house.

The key populations targeted by Healthy Markets face stigma and discrimination and often feel uncomfortable going to public facilities. Prior to the introduction of lay testing, HIV testing was only available in public hospitals or district health centers. In addition, a lack of counseling and support services offered alongside HIV testing reduced the number of people who were connected to treatment following diagnosis.

Since the program began last year, over 150 lay providers have been trained to offer quality rapid testing services, including counseling. The program is being rolled out in the urban centers of Ho Chi Minh City and the rural provinces of Dien Bien and Nghe An.

Lang Thi Nhat is a village health worker in Nghe An. Since her training in early March, she has tested over 38 high-risk clients and detected five new cases of HIV.

“Our clients know and trust us, and the procedure is very simple and convenient. One of the aspects our clients value most is that they don’t need to travel to get tested like before,” says Lang.

The initial results of the program in both urban and rural areas are very encouraging. In the first four months of service delivery, lay providers tested over 6,900 clients at high risk. Detection of new HIV cases has been particularly effective, with over 3.3 percent of rural clients testing HIV-positive and 8.4 percent of urban clients. The lay providers have supported 348 of the clients confirmed as HIV-positive to subsequently enroll in HIV care and treatment services.

The early success of the community-based HIV testing shows it is a crucial approach for increasing rates of regular testing among key populations, particularly those who have never accessed testing at a health facility.

“The program is responding into the real needs of a community that has been waiting for this a long time. We see there is great potential for fee-based services so [we can] sustain our work in the future,” says Nguyen Cong Hau, a lay provider serving MSM in Ho Chi Minh City through the G3VN community-based organization.

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