Yacin Benavides is a counselor who works on the front lines of HIV prevention among injection drug users in the city of Mayagüez, Puerto Rico. Working for the community-based organization, Estancia Corazon, he uses INSTI HIV tests in many non-traditional settings, and he has pioneered the revolutionary concept of “traffic light testing”.
HIV is a concerning health issue in Puerto Rico, which has the seventh highest rate of people living with HIV and the fifteenth highest rate of new HIV infections among U.S. states and territories. Estancia Corazon’s latest initiative provides HIV testing to some of the most vulnerable people in the community; the homeless population who regularly spend time at traffic lights, looking for spare change from passers by.
“INSTI has been an important tool for the traffic light testing project,” says Yacin, “We drive to the border of our city and work our way back to downtown. We pull over at traffic lights, where homeless people often gather, looking to get a little money. We offer them food, drinks and HIV testing.” He explains that during each green light as the cars pass by, he and a colleague can speak to the person, provide the food and drink, then run the test and provide an instant result. Throughout the process, Yacin and a colleague can give counseling and fill in paperwork associated with the test. Using only a car, two workers and INSTI HIV test kits, this project reaches up to 15 people in one day, many of whom may not normally access testing.
Estancia Corazon has its roots in some of the darkest day of the HIV crisis. It was founded as a hospice in 1991. “Back then we were seeing that a lot of HIV/AIDS patients were being abandoned by their family members, by their friends and most of them were dying on the streets. Estancia Corazon opened so that these people could have a place to stay, a place to live and a place to pass away in a dignified way,” says Yacin.
As HIV diagnosis, treatment and care evolves, so does the work of Estancia Corazon. Yacin says, “Today, we help people who inject drugs and sex workers; the people who society has kicked to the curb.” He explains that working with these groups presents unique challenges, saying, “In the past, we had to encourage people to consider testing, but then we found a second barrier: time.” The testing team were using traditional rapid HIV tests which take 20 minutes or more to deliver the result. Yacin says, “When you are working with drug users, they often can’t waste time. Time for them is money. No time, no money, no drugs. We couldn’t make them wait after their test, we had to rely on them to come back for their result. People didn’t come back. If we couldn’t find the person that day, we would have to come back and search for them, which took up time that we could have used to test others. It meant we had to cut off other programs, other activities.”
Yacin remembers when he first heard about INSTI and realized it could be the solution that Estancia Corazon desperately needed. “I was at a conference on HIV in Atlanta and saw posters about the one-minute test. I thought – you’ve got to be kidding me. I couldn’t believe it was real and it was perfect for us. I told my supervisor and quickly did the math, figuring out how productive it could actually be.” Once Yacin knew more about INSTI, he fought to make the local Department of Health understand its value for reaching their key populations. He told them, “I know it’s going to work. You’re going to have a problem with the other tests because I know people aren’t going to wait the 20 minutes. Very, very few people will do that in this situation. But they can wait 60 seconds.”
Yacin explains that the process with INSTI is simple, wherever you are testing. “With INSTI there is no wait, no need to come back. We fill out the paperwork and do the time-consuming part of counseling while the person eats or drinks… When we test, they just wait 60 seconds and they can leave with the result in their hand. We can continue to counsel them after the result and provide whatever kind of support they might need.” With INSTI, he says, they can test more people and provide a seamless process that includes counseling and HIV prevention advice.
As Yacin speaks, his devotion to helping others is evident. He says, “Working for a non-profit, money can’t be your only motivation. Just knowing that you can help someone doesn’t have a price. That’s the most satisfying feeling. Getting people off the streets, into rehab and knowing their status is so important. So is getting people to understand how vital treatment is and being able to link them to care or refer them to my coworkers. By providing the testing and the counseling, we help to reassure people that we will be there for them whatever the result, we remind them that they are not on their own.”