This case study demonstrates the theory of change working in practice. Through their engagement with their communities, alignment with the sector and their adaptation, The Queensland Council for LGBTI Health (QC) was able to achieve increased reach, increased effectiveness, increased efficiency, and stronger partnerships – all of which, led to better outcomes for their communities.
Pre-exposure prophylaxis – where HIV-negative people take HIV treatment medication to reduce their risk of contracting HIV – is a ‘game changer’ for the HIV epidemic. Known as PrEP, the use of ‘treatment as prevention’ has the potential to dramatically reduce HIV transmission and has already caused rapid shifts in attitudes, norms and stigma related to HIV, treatment and safe sex.
As an AIDS Council embedded in the Lesbian, Gay, Bisexual, Trans, Intersex and Queer (LGBTIQ) community in Queensland (engagement), QC is uniquely placed to understand and adapt to the rapid changes that PrEP is triggering in its community (adaptation). #ComePrepd is QC’s community-driven HIV prevention campaign that facilitates peer-to-peer learning and disseminates the latest scientific research on PrEP.
As one participant stated on the #ComePrepd website, which shares real stories about experiences with PrEP:
PrEP changes not only how I view sex and HIV but it also has the potential to change our community and our relationships, let’s make sure we change for the better.
QC’s innovative health education work harnesses sex and dating apps like Grindr and Scruff to direct people to the organisation’s Facebook and online material about #ComePrepd. These communication channels are more relevant to QC’s communities than print or other traditional media and therefore are more successful at reaching their target audience (increased reach and increased efficiency). QC also uses its access to community parties and events, and its understanding of what will be seen as acceptable and relevant to community members, to raise awareness of the #ComePrepd campaign, with strategies such as irreverent YouTube videos or models sporting underwear with the #ComePrepd logo (engagement). The campaign also uses honest stories, delivered by trusted peer educators, about both positive and negative experiences with PrEP to provide a more authentic message. This increases the credibility, and therefore effectiveness of the campaign (increased effectiveness).
#ComePrepd also creates a key link between the community and the QPrEPd study (alignment). The QPrEPd study is a demonstration project to examine “real world” PrEP use, and the feasibility, safety and effectiveness of PrEP in reducing HIV transmission in Queensland. Australia is home to some of the largest PrEP trials in the world, with AIDS Councils like QC playing an important role in community mobilisation and recruitment, increasing the reach of these studies. The QPrEPd study’s success to date, with the Queensland Government funding an expansion to 2000 places in April 2016, shows strong partnerships between QC and agencies like the Cairns and Hinterland Hospital and Health Service and the University of Queensland.
As the implications and potential of PrEP continue to unfold, QC continues to support peer leaders in their advocacy for increased availability and accessibility of PrEP, remaining committed to the goal of reducing HIV transmission in Australia.
