Implementation planning for community-based point-of-care HIV testing for infants: Recommendations from community leaders in Kenya

Background Community-based HIV testing services combined with the use of point-of-care tests (POCT) have the potential to improve early diagnosis through increasing availability, accessibility and uptake of HIV testing. Aim To describe community-based HIV testing activity in Catalonia, Spain, from 1995 to 2018, and to evaluate the impact of HIV POCT on the HIV continuum of care. Methods A community-based network of voluntary counselling and testing services in Catalonia, Spain has been collecting systematic data on activity, process and results since 1995. A descriptive analysis was performed on pooled data, describing the data in terms of people tested and reactive screening test results. Results Between 1995 and 2018, 125,876 HIV tests were performed (2.1% reactive). Since the introduction of HIV POCT in 2007, a large increase in the number of tests performed was observed, reaching 14,537 tests alone in 2018 (1.3% reactive). Men who have sex with men (MSM), as a proportion of all people tested, has increased greatly over time reaching 74.7% in 2018. The highest percentage of reactive tests was found in people who inject drugs followed by MSM. The contribution of community-based HIV testing to the overall total notified cases in the Catalonia HIV registry has gradually increased, reaching 37.9% in 2018, and 70% of all MSM cases. In 2018, the percentage of individuals with a reactive screening test who were linked to care was 89.0%. Conclusion Our study reinforces the important role that community-based HIV POCT has on the diagnosis of HIV in key populations.

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Preferences for rapid point-of-care HIV testing in Nova Scotia, Canada

Sexual Health ◽

10.1071/sh12100 ◽

2013 ◽

Vol 10 (2) ◽

pp. 124 ◽

Cited By ~ 11

Author(s):

Nathaniel M. Lewis ◽

Jacqueline C. Gahagan ◽

Carlye Stein

Keyword(s):

Nova Scotia ◽

North America ◽

Hiv Testing ◽

Point Of Care ◽

Urban Environments ◽

Health Clinic ◽

Test Results ◽

Community Based ◽

Hiv Test ◽

Timely Access

Rapid point-of-care (POC) testing for HIV has been shown to increase the uptake of testing, rates of clients receiving test results, numbers of individuals aware of their status and timely access to care for those who test positive. In addition, several studies have shown that rapid POC testing for HIV is highly acceptable to clients in a variety of clinical and community-based health care settings. Most acceptability studies conducted in North America, however, have been conducted in large, urban environments where concentrations of HIV testing sites and testing innovations are greatest. Using a survey of client preferences at a sexual health clinic in Halifax, Nova Scotia, we suggest that HIV test seekers living in a region outside of Canada’s major urban HIV epicentres find rapid POC testing highly acceptable. We compare the results of the Halifax survey with existing acceptability studies of rapid POC HIV testing in North America and suggest ways in which it might be of particular benefit to testing clients and potential clients in Nova Scotia and other regions of Canada that currently have few opportunities for anonymous or rapid testing. Overall, we found that rapid POC HIV testing was highly desirable at this study site and may serve to overcome many of the challenges associated with HIV prevention and testing outside of well-resourced metropolitan environments.

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Rapid point-of-care CD4 testing at mobile units and linkage to HIV care: an evaluation of community-based mobile HIV testing services in South Africa

BMC Public Health ◽

10.1186/s12889-020-08643-3 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Rosa Sloot ◽

Mary T. Glenshaw ◽

Margaret van Niekerk ◽

Sue-Ann Meehan

Keyword(s):

South Africa ◽

Hiv Testing ◽

Point Of Care ◽

Hiv Care ◽

Community Based ◽

Hiv Testing Services ◽

Linkage To Hiv Care ◽

Cd4 Testing

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Correction to: Findings from a novel and scalable community-based HIV testing approach to reduce the time required to complete point-of-care HIV testing in South Africa

BMC Health Services Research ◽

10.1186/s12913-021-07271-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tonderai Mabuto ◽

Geoffrey Setswe ◽

Nolundi Mshweshwe-Pakela ◽

Dave Clark ◽

Sarah Day ◽

...

Keyword(s):

South Africa ◽

Hiv Testing ◽

Point Of Care ◽

Community Based ◽

Testing Approach ◽

Time Required

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Observational study of the populations accessing rapid point-of-care HIV testing in Winnipeg, Manitoba, Canada, through a retrospective chart review of site records

Sexually Transmitted Infections ◽

10.1136/sextrans-2017-053195 ◽

2017 ◽

Vol 94 (3) ◽

pp. 194-199 ◽

Cited By ~ 4

Author(s):

James Blain Johnston ◽

Joss N Reimer ◽

John L Wylie ◽

Jared Bullard

Keyword(s):

Viral Load ◽

Hiv Testing ◽

Clinical Outcomes ◽

Point Of Care ◽

Age Groups ◽

Linkage To Care ◽

Hiv Positive ◽

Hiv Status ◽

Viral Load Suppression ◽

Hiv Test

ObjectivesHIV point-of-care testing (POCT) has been available in Manitoba since 2008. This study evaluated the effectiveness of POCT at identifying individuals with previously unknown HIV status, its effects on clinical outcomes and the characteristics of the populations reached.MethodsA retrospective database review was conducted for individuals who received HIV POCT from 2011 to 2014. Time to linkage to care and viral load suppression were compared between individuals who tested positive for HIV using POCT and controls identified as positive through standard screening. Testing outcomes for labouring women with undocumented HIV status accessing POCT during labour were also assessed.Results3204 individuals received POCT (1055 females (32.9%) and 2149 males (67.1%)), being the first recorded HIV test for 2205 (68.8%). Males were more likely to be targeted with POCT as their first recorded HIV test (adjusted OR (AOR) 1.40). Between the two main test sites (Main Street Project (MSP) and Nine Circles Community Health Centre), MSP tested relatively fewer males (AOR 0.79) but a higher proportion of members of all age groups over 30 years old (AOR 1.83, 2.51 and 3.64 for age groups 30–39, 40–49 and >50, respectively). There was no difference in time to linkage to care (p=0.345) or viral load suppression (p=0.405) between the POCT and standard screening cohorts. Of 215 women presenting in labour with unknown HIV status, one was identified as HIV positive.ConclusionsPOCT in Manitoba has been successful at identifying individuals with previously unknown HIV-positive status. Demographic differences between the two main testing sites support that this intervention is reaching unique populations. Given that we observed no significant difference in time to clinical outcomes, it is reasonable to continue using POCT as a targeted intervention.MeSH termsHIV infection; rapid HIV testing; vertical infectious disease transmission; community outreach; service delivery; marginalised populations.

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Feasibility and Success of Hiv Point-of-Care Testing in an Emergency Department in an Urban Canadian Setting

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2013/164797 ◽

2013 ◽

Vol 24 (1) ◽

pp. 27-31 ◽

Cited By ~ 15

Author(s):

Marissa L Becker ◽

Laura H Thompson ◽

Carla Pindera ◽

Natalie Bridger ◽

Carmen Lopez ◽

...

Keyword(s):

Emergency Department ◽

Hiv Testing ◽

Point Of Care ◽

Venous Blood ◽

Tertiary Care ◽

Antibody Test ◽

Cross Sectional Study ◽

Cross Sectional ◽

Post Test ◽

Centre Hospital

BACKGROUND: Approximately 26% of Canadians living with HIV are unaware of their status. Point-of-care (POC) HIV tests have been introduced to simplify and expand HIV testing.OBJECTIVE: To evaluate the feasibility and acceptability of POC testing in an emergency department (ED) setting in Winnipeg, Manitoba.METHODS: A cross-sectional study of unselected adults presenting to the ED at the Health Sciences Centre Hospital (Winnipeg, Manitoba) was performed. Study procedures included pre- and post-test counselling, administration of the INSTI HIV-1/HIV-2 Antibody Test (bioLytical Laboratories, Canada) and a brief questionnaire. Venous blood samples were collected from participants for confirmatory testing on all reactive and indeterminate specimens.RESULTS: In total, 501 adults participated in the study. The majority of participants were younger than 40 years of age, approximately one-half (48.5%) were women and 53% self-identified as Aboriginal. Nearly one-half (49.1%) of the participants had undergone previous HIV testing, although 63% of these tests were performed more than a year earlier. A total of seven individuals tested reactive with the POC test, all of whom were confirmed positive using serological testing (1.4%) and were linked to an HIV specialist within 24 h. Nearly all of the participants (96%) reported satisfaction with the test and believed it belonged in the ED (93%).CONCLUSIONS: Of the participants tested, 1.4% tested reactive for HIV, which is significantly higher than the reported prevalence in Manitoba and in other similar studies conducted in North America. Furthermore, all individuals were linked to timely care. The present study demonstrated that this particular busy tertiary care ED is an important and feasible location for HIV POC testing.

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Rapid Point-of-Care CD4 Testing at Mobile HIV Testing Sites to Increase Linkage to Care

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0b013e31825eec60 ◽

2012 ◽

Vol 61 (2) ◽

pp. e13-e17 ◽

Cited By ~ 73

Author(s):

Bruce A. Larson ◽

Kathryn Schnippel ◽

Buyiswa Ndibongo ◽

Thembisile Xulu ◽

Alana Brennan ◽

...

Keyword(s):

Hiv Testing ◽

Point Of Care ◽

Linkage To Care ◽

Cd4 Testing

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REACHING THE UNREACHED: UNIVERSAL ACCESS TO HIV TESTING FOR PREGNANT WOMEN THROUGH COMMUNITY BASED TESTING IN WEST BENGAL, INDIA

10.36106/7012560 ◽

2021 ◽

pp. 14-16

Author(s):

Suman Ganguly ◽

Debjit Chakrab

Keyword(s):

Pregnant Women ◽

Hiv Testing ◽

West Bengal ◽

Universal Access ◽

Community Based

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Addressing the challenges and relational aspects of index-linked HIV testing for children and adolescents: insights from the B-GAP study in Zimbabwe

10.21203/rs.3.rs-33333/v3 ◽

2020 ◽

Author(s):

Chido Dziva Chikwari ◽

Sarah Bernays ◽

Stefanie Dringus ◽

Victoria Simms ◽

Helen A Weiss ◽

...

Keyword(s):

Hiv Testing ◽

Children And Adolescents ◽

Negative Impact ◽

Discrete Event ◽

Routine Care ◽

Focus Group Discussions ◽

Group Discussions ◽

Community Based ◽

Testing Uptake ◽

Sexual Contacts

Abstract Introduction Index-linked HIV testing, targeted at sexual contacts or children of individuals with HIV, may improve yield and efficiency. The B-GAP study evaluated index-linked testing approaches in health facility and community-based settings. This paper reports on a qualitative study to understand factors that affect uptake of index-linked HIV testing for children and adolescents. Methods We conducted four focus group discussions (FGDs) with caregivers who had their children tested through B-GAP and one FGD with providers who offered index-linked HIV testing to indexes. We aimed to understand enabling and inhibiting factors in the decision-making process. Translated and transcribed transcripts were read for familiarisation. Following initial coding, analytical memos were written to identify emerging key themes across the data. Results Our findings showed there was inadequate emphasis on paediatric HIV in routine care which had a negative impact on subsequent uptake of testing for children. Once the decision to test had been made, access to facilities was sometimes challenging, and alleviated by community-based testing. A key finding was that HIV testing is not a discrete event but a process that was influenced by relationships with other family members and children themselves. These relationships raised complex issues that could prevent or delay the testing process. Conclusion There is a need to improve messaging on the importance of HIV testing for children and adolescents and to provide support to caregivers and their families in order to improve testing uptake. Addressing access barriers through the provision of community-based testing and implementing a family centred approach can optimize index-linked testing.

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