Operations research study to implement HIV and syphilis point-of-care tests and assess client perceptions in a marginalised area of Lima, Peru

Abstract

In Peru, a significant proportion of people tested for HIV and syphilis do not receive timely results. Our objective was to assess the institutional feasibility of implementing simultaneous HIV/syphilis point-of-care tests (POCTs) and client perceptions regarding these POCTs. POCTs were implemented in a hospital consultation room in a marginalized zone of Lima. A time-series design was used to compare the proportion of tested clients who received timely results, with and without the POCT intervention. Experience and satisfaction with POCTs was evaluated with 149 people. In the 6 months without intervention, 69% and 61% of clients tested for HIV and syphilis, respectively, received their results within the required 45-minute window. During the 2-month POCT intervention, all clients tested for HIV (n=387) and syphilis (n=398) received their results within 45 minutes. All clients surveyed were completely satisfied (52%) or satisfied (48%) with the simultaneous HIV/syphilis POCT screening process. Additionally, 73% strongly agreed with the statement “I feel satisfied with the rapid testing process.” Screening using POCTs represents an important opportunity to reduce the time, resource and cost burden for users and institutions and increase the proportion of users receiving their test results in a timely manner.

The need for further integration of services to prevent mother‐to‐child transmission of HIV and syphilis in Mwanza City, Tanzania

“…Dual point-of-care tests for HIV and syphilis, which meet the WHO ASSURED criteria of being Affordable, Sensitive, Specific, User-friendly, Rapid and robust, Equipment free, and Deliverable to those who need them, are now available [24]. Replacement of individual HIV and syphilis tests with these dual tests has occurred in some countries in South America [25] and will facilitate the integration of programs for PMTCT of HIV and syphilis, ensuring that all women screened for HIV are also screened for syphilis. …”

Toward Improving Accessibility of Point-of-Care Diagnostic Services for Maternal and Child Health in Low- and Middle-Income Countries

“…31 Studies have suggested that rapid HIV testing can increase HIV testing uptake, maternal HIV care, and uptake of ART. 32,33 The effect of rapid HIV testing on maternal linkage to HIV care was found in a systematic review and meta-analysis by Mashamba-Thompson et al 32 The availability of rapid tests for HIV including self HIV testing technologies has increased in LMICs. 33–39 Studies have demonstrated their acceptability and usefulness by increasing the proportion of pregnant women who are tested during ANC and provided same-day testing and treatment.…”

“…32,33 The effect of rapid HIV testing on maternal linkage to HIV care was found in a systematic review and meta-analysis by Mashamba-Thompson et al 32 The availability of rapid tests for HIV including self HIV testing technologies has increased in LMICs. 33–39 Studies have demonstrated their acceptability and usefulness by increasing the proportion of pregnant women who are tested during ANC and provided same-day testing and treatment. 33,34,39 Point-of-care HIV testing during time of labor and delivery offers the last opportunity for PMTCT in settings where women do not receive adequate ANC.…”

“…33–39 Studies have demonstrated their acceptability and usefulness by increasing the proportion of pregnant women who are tested during ANC and provided same-day testing and treatment. 33,34,39 Point-of-care HIV testing during time of labor and delivery offers the last opportunity for PMTCT in settings where women do not receive adequate ANC. 40 Although the uptake of PMTCT services particularly in Sub-Saharan Africa improved from 3% to 73% in 2003 and 2014, 31 integration of more PMTCT interventions including rapid HIV testing are still needed.…”

The role of Point-of-Care testing in the diagnosis of syphilis

“…POCT is generally well accepted by clients and health professionals to diagnose either HIV or syphilis, as demonstrated in Lima, Peru [57]; Manaus, Brazil [56]; India [40]; Kenya [58]; Tanzania [49,59]; China; Uganda; Zambia [49]; Canada [27]; and England [54]. Clients were satisfied in receiving the test results rapidly in the first visit [24,49], with no need to come back for results.…”