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The ‘Down to Test (DTT)’ program is an STI prevention social marketing program developed by the NSW Ministry of Health in collaboration with a marketing agency. The target audience was young people (15-29 years) attending selected music festivals in NSW and was delivered from September 2017 to March 2020. Audience insight research was used to determine the higher-risk segments of young people, according to values, attitudes and behaviours, to ensure effective targeting of the program towards these audiences. After pilot testing with members of the higher-risk segments of young people, the program was tailored specifically to increase STI testing behaviour in this population by increasing knowledge, positive attitudes and social norms for the behaviour. The program centred on the promotion of key messages to promote STI testing through festival activations and online social media channels. The NSW DTT social marketing program includes two key elements — face-to-face activations at music festivals and a concurrent digital media communication campaign. The face-to-face activations involved a ‘VIP area’ including clean toilets, a glitter make-up bar, and mobile phone charging docks. In order to access the VIP area, festival goers had to provide a urine specimen for chlamydia testing. Festival goers were required to register their name, brief demographic information, and contact details (phone numbers and email addresses) on an electronic tablet, to enable test result notification via SMS within a week after the event. Local young people were recruited to work as peer educators at each festival activation. Peer educators were trained in sexual health and STI information, the key program messages, how to engage with their peers, and a rapid risk response protocol (for dealing with uncomfortable or difficult situations). A concurrent digital media communication campaign which delivered key program messages was intended to raise program awareness pre-festival and encourage participation in face-to-face activations. Subsequent digital promotion was aimed at encouraging STI testing and driving traffic to a NSW-based youth STI promotion website (i.e., ).

For monitoring and evaluation, a pre-post program exposure design was applied using repeated, cross-sectional online surveys, according to a pre-determined program logic model informed by the Transtheoretical (Stages of Change) Model of Health Behavior Change. The pre-exposure (baseline) survey targeted young people aged 15-29 years old living in NSW who had purchased tickets for music festivals as directed by a commercial panel recruitment process and was completed in September 2017. The post-exposure (follow-up) surveys targeted similar 15-29-year-olds who visited the onsite DTT activations at pre-determined NSW music festivals. These post-exposure surveys were conducted between 1-3 weeks after each event.