A systematic review of HIV testing among Canadian populations

Ha, Shalane; Paquette, Daniel; Tarasuk, Jill; Dodds, J; Gale-Rowe, M; Brooks, James; Kim, John; Wong, Tom

doi:10.17269/cjph.105.4128

Cited by 17 publications

(4 citation statements)

References 22 publications

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“…Previous systematic reviews have investigated the utilization of conventional HIV testing in Canadian settings ( 13 ), the barriers associated with HIV POCT in an international context ( 14 ), as well as the acceptability of HIV self-testing including participants’ attitudes and testing uptake ( 15 ). This scoping review adds to the literature by focusing on the utilization of HIV POCT in Canada.…”

Section: Introductionmentioning

confidence: 99%

HIV Point-of-Care Testing in Canadian Settings: A Scoping Review

Minichiello

Swab

Chongo

et al. 2017

Front. Public Health

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BackgroundHIV point-of-care testing (POCT) was approved for use in Canada in 2005 and provides important public health benefits by providing rapid screening results rather than sending a blood sample to a laboratory and waiting on test results. Access to test results soon after testing (or during the same visit) is believed to increase the likelihood that individuals will receive their results and improve access to confirmatory testing and linkages to care. This paper reviews the literature on the utilization of HIV POCT across Canadian provinces.MethodsWe searched OVID Medline, Embase, EBM Reviews, PsycINFO, CINAHL, and 20 electronic grey literature databases. All empirical studies investigating HIV POCT programs in Canada published in French or English were included.ResultsSearches of academic databases identified a total of 6,091 records. After removing duplicates and screening for eligibility, 27 records were included. Ten studies are peer-reviewed articles, and 17 are grey literature reports. HIV POCT in Canada is both feasible and accepted by Canadians. It is preferred to conventional HIV testing (ranging from 81.1 to 97%), and users are highly satisfied with the testing process (ranging between 96 and 100%).ConclusionThe majority of studies demonstrate that HIV POCT is feasible, preferred, and accepted by diverse populations in Canada. Losses to follow-up and linkage rates are also good. However, more research is needed to understand how best to scale up HIV POCT in contexts that currently have very limited or no access to testing.

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Section: Introductionmentioning

confidence: 99%

HIV Point-of-Care Testing in Canadian Settings: A Scoping Review

Minichiello

Swab

Chongo

et al. 2017

Front. Public Health

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“…This grading system has been used by the Public Health Agency of Canada in the development of recent infection prevention and control guidelines (5,7). The toolkit has also been used for conducting critical appraisal for other purposes, such as addressing a practice problem and serving as an educational tool (8,9).…”

Section: Implementation Sciencementioning

confidence: 99%

Critical Appraisal Toolkit (CAT) for assessing multiple types of evidence

Moralejo

Ogunremi

Dunn

2017

Canada Communicable Disease Report

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Healthcare professionals are often expected to critically appraise research evidence in order to make recommendations for practice and policy development. Here we describe the Critical Appraisal Toolkit (CAT) currently used by the Public Health Agency of Canada. The CAT consists of: algorithms to identify the type of study design, three separate tools (for appraisal of analytic studies, descriptive studies and literature reviews), additional tools to support the appraisal process, and guidance for summarizing evidence and drawing conclusions about a body of evidence. Although the toolkit was created to assist in the development of national guidelines related to infection prevention and control, clinicians, policy makers and students can use it to guide appraisal of any health-related quantitative research. Participants in a pilot test completed a total of 101 critical appraisals and found that the CAT was user-friendly and helpful in the process of critical appraisal. Feedback from participants of the pilot test of the CAT informed further revisions prior to its release. The CAT adds to the arsenal of available tools and can be especially useful when the best available evidence comes from non-clinical trials and/or studies with weak designs, where other tools may not be easily applied.

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“…Despite having high levels of condomless sex, approximately 43% of TGBM in Ontario had never been tested for HIV, leading to possible underdiagnosis of HIV in the TGBM population in Ontario [ 8 ]. In the general Canadian GBM population, approximately 17% had never been tested, a dramatic difference from their TGBM peers in Ontario [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Cisnormativity as a structural barrier to STI testing for trans masculine, two-spirit, and non-binary people who are gay, bisexual, or have sex with men

et al. 2022

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Trans masculine, two-spirit, and non-binary people who are gay, bisexual or otherwise have sex with men (TGBM) are under-tested for sexually transmitted infections (STI) and may face complex, intersectional barriers that prevent them from accessing STI testing. As part of a study on gay, bisexual and other men who have sex with men’s (GBM) experiences of current STI testing systems in Ontario, Canada, this paper reports on the findings from TGBM participants’ experiences with in-person STI testing in a range of venues (i.e. Family doctors, walk-in clinics, and community-based organizations) to explore testing barriers specific to TGBM. Using a community-based research approach, between June 2020 and December 2021 peer researchers who identified as GBM conducted focus groups and interviews with 38 cis and trans GBM, 13 of whom identified as TGBM. Data were analyzed following grounded theory. When questioned about past experiences with testing, TGBM participants reported several barriers to STI testing within current testing models in Ontario due to cisnormativity and heteronormativity. Cisnormativity is the assumption that everyone identifies as the gender they were assigned at birth, and those who do not are considered “abnormal”, while heteronormativity is when it is assumed that everyone is heterosexual. From our research we identified three overarching themes concerning testing barriers among TGBM participants: (1) non-inclusive clinic environments, (2) lack of provider knowledge and competency, and (3) legal documentation. Inherent cis and heteronormativity in healthcare institutions appear to be factors shaping the historical under-testing for STI in the TGBM population. These findings suggest the relevance of implementing trans-specific clinical practices that reduce the stigma and barriers faced by TGBM in STI testing contexts, including: hosting all-gender testing hours, opening more LGBTQ+ clinics, offering training in transgender health to testing providers, and conducting a review of how gender markers on health documents can be more inclusive of trans, two-spirit, and non-binary communities.

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A systematic review of HIV testing among Canadian populations

Cited by 17 publications

References 22 publications

HIV Point-of-Care Testing in Canadian Settings: A Scoping Review

HIV Point-of-Care Testing in Canadian Settings: A Scoping Review

Critical Appraisal Toolkit (CAT) for assessing multiple types of evidence

Cisnormativity as a structural barrier to STI testing for trans masculine, two-spirit, and non-binary people who are gay, bisexual, or have sex with men

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