Point-of-care testing (POCT) for HIV/STI targeting MSM in regional Australia at community ‘beat’ locations

Mullens, Amy B.; Duyker, Josh; Brownlow, Charlotte; Lemoire, Jime; Daken, Kirstie; Gow, Jeff

doi:10.1186/s12913-019-3899-2

Cited by 17 publications

(15 citation statements)

References 33 publications

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“…4,5 The availability of rapid POCT for HIV and syphilis within community settings has enabled a variety of innovative, MSM peer-based services for the early detection of infection. [6][7][8][9] Recent developments in nucleic acid amplification tests (NAAT), such as automated molecular technologies 10 for the detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), facilitates greater breadth of STI testing within community settings. 10,11 It also creates compelling opportunities for enhancing an integrated primary sexual healthcare approach that promises greater accessibility and equity to comprehensive STI testing for those most at risk.…”

Section: Introductionmentioning

confidence: 99%

Peer-delivered point-of-care testing for Chlamydia trachomatis and Neisseria gonorrhoeae within an urban community setting: a cross-sectional analysis

Bell

Coffey²,

Debattista

et al. 2020

Sex. Health

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Background The advent of fully automated nucleic acid amplification test (NAAT) technology brings new public health opportunities to provide Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) point-of-care testing (POCT) in non-traditional settings. Methods: This pilot study evaluated the integration of the CT/NG Xpert diagnostic assay into an urban peer-led community setting providing HIV and syphilis POCT. A comprehensive protocol of testing, result notification, referral and follow up, managed by peer test facilitators, was undertaken. Results: Over 67 weeks, there were 4523 occasions of CT/NG testing using urine, oropharyngeal and anorectal samples with 25.7% (803) of the 3123 unique participants returning for repeat testing. The prevalence of CT and NG was 9.5% and 5.4% respectively. Where CT and or NG infection was detected, 98.4% (604/614) of participants were successfully notified of detected infection and referred for treatment. Evaluation Survey responses (11.4%, 516/4523) indicated a substantial proportion of respondents (27.1%, 140/516) ‘would not have tested anywhere else’. Of note, 17.8% (92/516) of participants reported no previous CT/NG test and an additional 17.8% (92/516) reported testing more than 12 months ago. A total of 95.9% (495/516) of participants ‘Strongly agreed’ or ‘Agreed’ to being satisfied with the service. Conclusion: The project successfully demonstrated an acceptable and feasible model for a peer-delivered community-led service to provide targeted molecular CT/NG POCT. This model offers capacity to move beyond the traditional pathology and STI testing services and establish community-led models that build trust and increase testing rates for key populations of epidemiological significance.

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Section: Introductionmentioning

confidence: 99%

Peer-delivered point-of-care testing for Chlamydia trachomatis and Neisseria gonorrhoeae within an urban community setting: a cross-sectional analysis

Bell

Coffey²,

Debattista

et al. 2020

Sex. Health

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“…However, mobile testing facilities, nonclinician staffing, and after-hours availability have demonstrated variable success. [31][32][33] This study sought to understand how YBMSM balance the trade-off among various testing attributes.…”

Section: Discussionmentioning

confidence: 99%

Human Immunodeficiency Virus/Sexually Transmitted Infection Testing Preferences for Young Black Men Who Have Sex With Men in the Southeastern United States: Implications for a Post–COVID-19 Era

et al. 2021

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Background: Little is known regarding human immunodeficiency virus (HIV)/sexually transmitted infection (STI) testing preferences for location, staffing, and hours of operation among Young Black men who have sex with men (YBMSM) in the Southeastern United States, a population at high risk for HIV/STIs. We used a discrete choice experiment to explore these preferences.Methods: Young Black men who have sex with men ages 16 to 35 years in Birmingham, AL and Jackson, MS completed online surveys evaluating their preferences (best/worst) for HIV/STI testing locations, staffing, hours, method of results notification, and cost. They also selected preferred combinations of these variables through choice tasks. Results were analyzed using joint best/worst and discrete choice experiment models.Results: Between June 2018 and December 2019, participants in Alabama (n = 54) and Mississippi (n = 159) completed online surveys. Both groups preferred stationary testing locations over mobile testing vans, with the most significant difference favoring STI testing-only clinics in Mississippi and local health departments in Alabama ( P < 0.001). Technician-performed tests or self-testing were significantly less preferred compared with clinicianperformed testing for both groups ( P < 0.0001 and P < 0.0001, respectively). Free testing and phone results notification (versus text) were preferred by both groups. The most desirable combination among all participants was weekday clinician-performed testing at the health department for $5.Conclusions: Young Black men who have sex with men in the Southeastern United States prefer traditional testing locations staffed by experienced personnel. Combination choices are influenced by services that are low or no cost. More research is needed to inform the best way(s) to provide affordable, high-quality HIV/STI testing services for YBMSM, particularly in the post-COVID-19 era when sexual health care delivery models are evolving toward home-based and remote health-focused strategies.

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“…Second, we found settings that had rapid point-ofcare HIV testing available markedly increased concurrent HIV/STI testing. Rapid testing for HIV/syphilis has high acceptability amongst clients [49][50][51][52][53] and could decrease anxiety related to waiting for results, increase convenience, and provide greater confidentiality [49,52]. Third, when HIV testing was integrated into standard STI care protocols, this delivered more consistent performance across clinics [45].…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

Missed opportunities for HIV testing among those who accessed sexually transmitted infection (STI) services, tested for STIs and diagnosed with STIs: a systematic review and meta-analysis.

Saleem

Ting

Loh

et al. 2022

Preprint

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Introduction: Of 37.7 million people living with HIV in 2020, 6.1 million still do not know their HIV status. We synthesise evidence on concurrent HIV testing among people who tested for other sexually transmitted infections (STI). Methods: We conducted a systematic review using five databases, HIV conferences and clinical trial registries. We included publications between 2010 and May 2021 that reported primary data on concurrent HIV/STI testing. We conducted a random-effects meta-analysis and meta-regression of the pooled proportion for concurrent HIV/STI testing. Results and discussion: We identified 96 eligible studies: the majority (73%) were from high-income countries (HIC), with a third from general populations (36%) and non-heterosexual populations (30%). Among the 96 studies, 18 studies had relevant data for a meta-analysis for the proportion of people tested for HIV among those attending a clinic with STI testing services, 15 studies among those tested for other STIs, 13 studies among those diagnosed with STI and three studies for people with STI symptoms. The remaining studies provided data on the acceptability, feasibility, barriers, facilitators, economic evaluation and social harms of concurrent HIV/STI testing. The pooled proportion of people tested for HIV among those attending an STI service (n=18 studies) was 71.0% [95% confidence intervals: 61.0-80.1, I2=99.9%], people tested for HIV among those who were tested for STIs (n=15) was 61.3% [53.9-68.4, I2=99.9%], people tested for HIV among those who were diagnosed with an STI (n=13) was 35.3% [27.1-43.9, I2=99.9%]. and people tested for HIV among those presenting with STI symptoms (n=3) was 27.1% [20.5-34.3, I2=92.0%]. The meta-regression analysis found that heterogeneity was driven mainly by identity as a sexual minority, the latest year of study, country-income level and region of the world. Conclusions: Not testing for HIV amongst people using STI services presents a significant missed opportunity, particularly among those diagnosed with an STI. Stronger integration of HIV and STI services is urgently needed to improve prevention, early diagnosis, and linkage to care services. PROSPERO Number: CRD42021231321

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Point-of-care testing (POCT) for HIV/STI targeting MSM in regional Australia at community ‘beat’ locations

Cited by 17 publications

References 33 publications

Peer-delivered point-of-care testing for Chlamydia trachomatis and Neisseria gonorrhoeae within an urban community setting: a cross-sectional analysis

Peer-delivered point-of-care testing for Chlamydia trachomatis and Neisseria gonorrhoeae within an urban community setting: a cross-sectional analysis

Human Immunodeficiency Virus/Sexually Transmitted Infection Testing Preferences for Young Black Men Who Have Sex With Men in the Southeastern United States: Implications for a Post–COVID-19 Era

Missed opportunities for HIV testing among those who accessed sexually transmitted infection (STI) services, tested for STIs and diagnosed with STIs: a systematic review and meta-analysis.

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