At-home HIV self-testing during COVID: implementing the GetaKit project in Ottawa

Abstract

Setting In March 2020, COVID-19 shuttered access to many healthcare settings offering HIV testing and there is no licensed HIV self-test in Canada. Intervention A team of nurses at the University of Ottawa and Ottawa Public Health and staff from the Ontario HIV Treatment Network (OHTN) obtained Health Canada’s Special Access approval on April 23, 2020 to distribute bioLytical’s INSTI HIV self-test in Ottawa; we received REB approval on May 15, 2020. As of July 20, 2020, eligible participants (≥18 years old, HIV-negative, not on PrEP, not in an HIV vaccine trial, living in Ottawa, no bleeding disorders) could register via www.GetaKit.ca to order kits. Outcomes In the first 6 weeks, 637 persons completed our eligibility screener; 43.3% (n = 276) were eligible. Of eligible participants, 203 completed a baseline survey and 182 ordered a test. These 203 participants were an average of 31 years old, 72.3% were white, 60.4% were cis-male, and 55% self-identified as gay. Seventy-one percent (n = 144) belonged to a priority group for HIV testing. We have results for 70.9% (n = 129/182) of participants who ordered a kit: none were positive, 104 were negative, 22 were invalid, and 2 “preferred not to say”; 1 participant reported an unreadiness to test. Implications Our results show that HIV self-testing is a pandemic-friendly strategy to help ensure access to sexual health services among persons who are good candidates for HIV testing. It is unsurprising that no one tested positive for HIV thus far, given the 0.08% positivity rate for HIV testing in Ottawa. As such, we advocate for scale-up of HIV self-testing in Canada.

HIV service delivery in the time of COVID‐19: focus group discussions with key populations in India

“…HIV programs globally saw fewer clients living with HIV complete HIV RNA testing over the initial months of COVID‐19 compared to pre‐pandemic [ 18 ]. Public health programs can help restore testing service utilization by exploring innovative solutions, such as delivering testing through community health workers or incorporating HIV self‐testing into service delivery [ 19 , 20 , 21 ]. These strategies may be particularly important to maintain access to HIV diagnosis and RNA testing for KPs, who already face socio‐structural access barriers, especially if travel or facility disruptions from COVID‐19 continue.…”

La pandémie et le dépistage du cancer du col

“…Il a été démontré dans des programmes pilotes au Mexique, en Argentine, en Australie et dans divers pays européens que ces types de trousses d'autoprélèvement augmentent la participation au dépistage du cancer du col 17 . Un programme expérimental de test de détection du VIH par autoprélèvement à Ottawa (Ontario) en 2020 a démontré que les tests d'autoprélèvement envoyés par la poste sont utiles pour aider à maintenir l'accès au dépistage durant des interruptions dans les soins continus, comme celles causées par une pandémie 18 . De nombreuses provinces, dont l'Ontario et la Colombie-Britannique ont déjà l'infrastructure voulue pour poster du matériel de dépistage du cancer aux personnes admissibles; il suffit de penser, par exemple, aux tests immunochimiques des selles postés à des millions de personnes au pays 19,20 .…”

The pandemic and cervical cancer screening

“…17 A trial HIV self-testing program in Ottawa, Ont, in 2020 demonstrated that mailed self-tests are useful in helping to maintain screening access during disruptions in ongoing care, such as during a pandemic. 18 Many provinces like Ontario and British Columbia already have the infrastructure to mail cancer screening materials to eligible patients; as an illustration, one need look no further than the fecal immunochemical tests mailed to millions across the country. 19,20 The option of self-swabbing would also benefit those already facing barriers to accessing primary care services, such as those from lower-income backgrounds, immigrants in urban settings, Indigenous people who might live far from a provider, and parents unable to arrange transportation or child care to come to clinic.…”