Impact of the introduction of rapid HIV testing in the Voluntary Counselling and Testing sites network of Catalonia, Spain

Fernàndez‐López, Laura; Rifà, Benet; Pujol, Ferran; Becerra, J; Pérez, Martha; Meroño, Merçè; Zaragoza, Kati; Rafel, Anna; Dı́az, Olga; Avellaneda, A; Casado, María Jesús; Giménez, Albert; Casabona, Jordi

doi:10.1258/ijsa.2008.008459

Cited by 31 publications

(26 citation statements)

References 7 publications

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“…The prevalence of infection (1% overall and 3.8% in MSM) is similar to that found in other programmes not aimed at high-risk groups [35,36] and slightly higher than that found in the only previous paper published on in-pharmacy testing, in another Spanish region (0.85%) [17] It is three times higher than that found in a study of the use of pharmacies as a recruitment site [16].…”

Section: Discussionsupporting

confidence: 81%

The rapid test in Spanish pharmacies: a novel programme to reach heterosexual men?

et al. 2015

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Spain has been a pioneer in the implementation of rapid HIV testing programmes in pharmacies to increase access to testing. However, no formal evaluation of the effectiveness of these programmes has been carried out to date. Our aim was to evaluate the ability of a novel in-pharmacy rapid HIV testing programme to promote diagnosis and reach vulnerable populations. MethodsBetween 2011 and 2012, 2168 people underwent testing in 16 urban pharmacies in 10 cities of a Spanish region with a low prevalence of HIV infection. The main outcomes of the programme were compared with those of the regional surveillance system for new HIV diagnoses (RHSS-CyL). ResultsOverall, 52.8% of those tested were heterosexual men, 15.8% were men who have sex with men (MSM) and 25.3% were women. Nine per cent were immigrants and 41.9% were < 30 years old. In total, 59.5% of the heterosexual men, 44.6% of the MSM and 65.3% of the women were previously untested. There were 23 positive results, representing 6% of all new regional diagnoses in 2011. The global prevalence was 1.1% (95% confidence interval 0.6-1.5%) and the prevalence in MSM was 3.8%. Of the reactive results, 60.9% were in MSM, 34.8% in heterosexual men and only 4.3% in women, vs. 35.4%, 37.5% and 15.0%, respectively, reported by the RHSS-CyL. The mean age of those testing positive was 32.7 years vs. 38.7 years in the RHSS-CyL. Fifty per cent of MSM and 75% of heterosexual men testing positive were previously untested. ConclusionsIn Spain, this is the first programme not targeted at the most at-risk populations, and has been shown to be effective in reaching and diagnosing heterosexual men, who are the group most affected by delayed diagnoses. Heterosexual men accounted for over half of those tested and a third of those diagnosed, and most of them were previously untested. Young and previously untested MSM also greatly benefitted from the programme. IntroductionDelayed diagnosis of HIV infection is associated with higher morbidity and mortality and with a poorer response to treatment. It is also associated with higher viral loads which, combined with a higher frequency of unprotected In order to overcome possible barriers, numerous programmes promoting and performing the test outside traditional settings have been launched. Most of these programmes have shown to be highly effective in capturing key populations at risk, such as men who have sex with men (MSM) [10]. However, European surveillance data show that the highest rates of late diagnosis are found in heterosexuals [11]. Some initiatives to reach this population have shown relatively poor outcomes [12], making heterosexual men one of the most difficult groups to reach for early diagnosis.In-pharmacy HIV testing services have been considered for several years as a novel strategy to make HIV testing more accessible to the general population [13]. Pharmacists have a very favourable attitude towards providing HIV testing and counselling [14]. Nevertheless, there is only one ongoing pilot study on the feasibility of routinely ...

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Section: Discussionsupporting

confidence: 81%

The rapid test in Spanish pharmacies: a novel programme to reach heterosexual men?

et al. 2015

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“…This review identified a limited number of testing initiatives that demonstrated an increase in HIV testing, as a conseqence of a lack of reporting of baseline data or control data. Only two comparative studies presented data documenting changes to the number tested over time . One study, describing a community‐based voluntary counselling and testing service for MSM, showed a scale‐up from 951 tests carried out in 2009 to more than 4049 in 2012; reactivity over this period remained stable (3.9% in 2007; 3.4% in 2012) .…”

Section: Resultsmentioning

confidence: 99%

HIV testing strategies outside of health care settings in the European Union (EU)/European Economic Area (EEA): a systematic review to inform European Centre for Disease Prevention and Control guidance

et al. 2019

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Objectives In recent years, new technologies and new approaches to scale up HIV testing have emerged. The objective of this paper was to synthesize the body of recent evidence on strategies aimed at increasing the uptake and coverage of HIV testing outside of health care settings in the European Union (EU)/European Economic Area (EEA). Methods Systematic searches to identify studies describing effective HIV testing interventions and barriers to testing were run in five databases (2010–2017) with no language restrictions; the grey literature was searched for similar unpublished studies (2014–2017). Study selection, data extraction and critical appraisal were performed by two independent reviewers following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Results Eighty studies on HIV testing in non‐health care settings were identified, the majority set in Northern Europe. Testing was implemented in 65 studies, with men who have sex with men the risk group most often targeted. Testing coverage and positivity/reactivity rates varied widely by setting and population group. However, testing in community and outreach settings was effective at reaching people who had never previously been tested and acceptability of HIV testing, particularly rapid testing, outside of health care settings was found to be high. Other interventions aimed to increase HIV testing identified were: campaigns (n = 8), communication technologies (n = 2), education (n = 3) and community networking (n = 1). Conclusions This review has identified several strategies with potential to achieve high HIV testing coverage outside of health care settings. However, the geographical spread of studies was limited, and few intervention studies reported before and after data, making it difficult to evaluate the impact of interventions on test coverage.

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“…Despite an extensive number of interventions that seek to increase knowledge of HIV serostatus among MSM, global test uptake remains low (Arreola, Hebert, Makofane, Beck, & Ayala, 2012). Barriers to accessing HIV services at traditional health care settings are numerous (Krause, Subklew-Sehume, Kenyon, & Colebunders, 2013; Myers, El-Sadr, Zerbe, & Branson, 2013; Song et al, 2011; Tucker, Bien, & Peeling, 2013) and have led to a significant increase in alternative programmes that offer rapid, point-of-care HIV testing in community-based settings (Bowles et al, 2008; Fernandez-Lopez et al, 2010). Globally, rapid tests for HIV have been used for almost a decade, but the need to attend a health facility has severely impeded test uptake among key populations (Tucker et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

HIV test uptake among MSM in China: Implications for enhanced HIV test promotion campaigns among key populations

Han

Wei

Muessig

et al. 2016

Global Public Health

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Despite global efforts to increase HIV test uptake among men who have sex with men (MSM), social stigma and negative attitudes toward homosexuality hinder the effectiveness of traditional test promotion campaigns. Increasing HIV test uptake requires greater understanding of the conditions that facilitate decisions to get tested. We conducted an online survey hosted by two of the most highly frequented MSM web portals in China. A generalised ordered logistic regression analysis was conducted to determine factors associated with HIV testing behaviour. Compared to men who had never tested for HIV, men who had tested in the past year were more likely to have never engaged in sex with women, have multiple male sex partners in the past 3 months and have disclosed their sexual orientation to others. MSM found testing at local Chinese Centers for Disease Control and Prevention (80.7%), gay men’s community-based organisations (80.2%) and public hospitals (70.9%) to be acceptable, while saunas (50.5%) and gay bars (41.8%) were found to be unacceptable testing venues. Our study shows that MSM in China prefer to test at venues that guarantee confidentiality, quality and quick results. Our study also suggests that self-testing may be a feasible approach to increase test uptake.

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Impact of the introduction of rapid HIV testing in the Voluntary Counselling and Testing sites network of Catalonia, Spain

Cited by 31 publications

References 7 publications

The rapid test in Spanish pharmacies: a novel programme to reach heterosexual men?

The rapid test in Spanish pharmacies: a novel programme to reach heterosexual men?

HIV testing strategies outside of health care settings in the European Union (EU)/European Economic Area (EEA): a systematic review to inform European Centre for Disease Prevention and Control guidance

HIV test uptake among MSM in China: Implications for enhanced HIV test promotion campaigns among key populations

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