Health Equity + Wellbeing

Designing a Safe and Supportive HIV Testing Experience

A discreet, yet emboldening HIV testing experience for men in Zimbabwe

In Zimbabwe, a country where homosexuality is criminalized, LGBTQIA+ people live in fear of being ostracized and punished by their communities, their families, and the law. This not only makes navigating relationships and institutions incredibly burdensome, it also prevents many of them from seeking and getting the care they need.

Although men who have sex with men (MSM) in Zimbabwe are 27 times more likely to acquire HIV than the general population, the fear of social fallout outweighs the fear of HIV. Population Services International Zimbabwe partnered with IDEO​.org to design a more supportive and safe HIV testing experience for MSM, particularly for older men, who were getting tested less. 

After interviewing providers and clients, a health provider guided the design team through the process of getting tested. This illuminated how confusing, humiliating, and drawn out the experience is for clients. Team members were ping-ponged back and forth between rooms, hallways, and foyers, asked sensitive questions with judgement, and waited for results in a public space where they could potentially run into someone they knew. It was evident that the clinic only reinforced feelings of isolation and fear that clients already felt going in. 

We found that each was on his own journey, moving fluidly between states of fear, shame, belonging, and security—regardless of age. Over the course of three months, we worked alongside providers and MSM to co-create a service where men can access HIV services discreetly, safely, and at their own pace. 

Subtle but recognizable lanyards for trained providers signal to clients that they are “in the know” and can be trusted.

Discreet signage welcomes him and leads him from entrance to the private waiting room.

The service manages to be both bold and inconspicuous—showing up as a colorful brand in trusted spaces (like WhatsApp groups or physical safe spaces in Harare) then in more muted ways in public clinics and on the exteriors of the buildings. In its highest expression, the brand and experience aim to create conditions for men to feel free to be themselves.

Today, every touchpoint of the experience—from entering to waiting to testing—is a streamlined flow that optimizes for efficiency and privacy. Instead of entering a public waiting room, clients learn about a special, private room through word of mouth. The waiting experience was completely reimagined to make sure clients know what to expect and know that others have been there before. In the waiting room walls, there are prompts that invite clients to share handwritten notes of encouragement or a story of their own; and they also have the option of playing videos that demystify the testing experience.

The Whatsapp group serves as a credible presence in the community, meant to foster dialogue and demystify the clinic experience.

The service identity was designed to be both covert and easy to recognize.

The brand builds trust among the community, starting outside of the clinic, and extending to service delivery moments inside the clinic. The logo was designed to be both covert and easy to recognize. Subtle signage helps people visiting find their way without fear or shame of asking. It’s designed to look like a speech bubble (that gives MSM a voice) as well as a room with a door that is always open.

The service is currently being tested in clinics in Zimbabwe and has seen promising results, with client flow increasing due to the client experience improvements and branded social media efforts.

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