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BMC Public Health
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

HIV rapid testing in community and outreach sites: results of a nationwide demonstration project in Italy

Authors: Paola Scognamiglio, Giacomina Chiaradia, Marta Giovanetti, Emidio Albertini, Antonella Camposeragna, Massimo Farinella, Daniela Lorenzetti, Massimo Oldrini, Laura Rancilio, Anna Caraglia, Francesco Paolo Maraglino, Giuseppe Ippolito, Enrico Girardi

Published in: BMC Public Health | Issue 1/2018

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Abstract

Background

Globally the access to HIV testing has greatly increased over the past 30 years. Nonetheless, a high proportion of people living with HIV remains undiagnosed, even in resource rich countries. To increase the proportion of people aware of their HIV serostatus and their access to medical care, several strategies have been proposed including HIV rapid test programs offered outside health facilities. The aim of this project was to evaluate the feasibility and efficacy of the HIV rapid testing offered in community and outreach settings in Italy.

Methods

We conducted a national demonstration project on HIV rapid tests offered in community and outreach settings, including nongovernmental organization (NGO) facilities, primary care services for migrants and low-threshold services or mobile units for drug users (DU services). HIV rapid test on oral fluid (OraQuick®; Orasure Technologies) was anonymously offered to eligible people who presented themselves at the selected sites. Those with reactive results were referred to a specialized outpatient unit for confirmatory testing and medical care.

Results

Over a period of six months a total of 2949 tests were performed and 45.2% of individuals tested had not been previously tested. Overall 0.9% (27/2949) of tested people had a preliminary positive test. In NGO facilities the positivity rate was 1%. All subjects who performed their confirmatory test were confirmed as positive. In services for migrants the positivity rate was 0.5 and 80% were referred to care (with 1 false positive test). In DU services we observed the highest positivity rate (1.4%) but the lowest linkage to care (67%), with 1 false positive test.

Conclusion

Our project showed that the offering of an HIV rapid testing program in community and outreach settings in Italy is feasible and that it may reach people who have never been tested before, while having a significant yield in terms of new HIV diagnoses as well.
Literature
1.
Montaner JS, Hogg R, Wood E, Kerr T, Tyndall M, Levy AR, Harrigan PR. The case for expanding access to highly active antiretroviral therapy to curb the growth of the HIV epidemic. Lancet. 2006;368:531–6.CrossRefPubMed
2.
Jones A, Cremin I, Abdullah F, Idoko J, Cherutich P, Kilonzo N, Rees H, et al. Transformation of HIV from pandemic to low-endemic levels: a public health approach to combination prevention. Lancet. 2014;384:272–9.CrossRefPubMed
3.
4.
Easterbrook P, Johnson C, Figueroa C, Baggaley R. HIV and Hepatitis testing: global progress, challenges, and Future Directions. AIDS Rev. 2016;18:3–14.PubMed
5.
Song R, Hall HI, Green TA, Landmann Szwarcwald C, Pantazis N. Using CD4 data to estimate HIV incidence, prevalence and percent of undiagnosed infections in the United States. J Acquir Immune Defic Syndr. 2017;74:3–9.CrossRefPubMed
6.
7.
Hall HI, Holtgrave DR, Maulsby C. HIV transmission rates from persons living with HIV who are aware and unaware of their infection. AIDS. 2012;26:893–6.CrossRefPubMed
8.
Skarbinski J, Rosenberg E, Paz-Bailey G, Hall HI, Rose CE, Viall AH, Fagan JL, Lansky A, Mermin JH. Human immunodeficiency virus transmission at each step of the care continuum in the United States. JAMA Intern Med. 2015;175:588–96.CrossRefPubMed
9.
Ratmann O, van Sighem A, Bezemer D, Gavryushkina A, Jurriaans S, Wensing A, de Wolf F, Reiss P, Fraser C. ATHENA observational cohort. Sources of HIV infection among men having sex with men and implications for prevention. Sci Transl Med. 2016;8:320–2.CrossRef
10.
11.
12.
13.
14.
Colucci A, Luzi AM, Gallo P, D’Amato S and Pompa MG. Adherence to HIV screening tests: results of a project of the Ministry of Health developed by the Istituto Superiore di Sanità (Italian National Institute of health) and the council for the fight against AIDS 2011, vi, 174 p. Rapporti ISTISAN 11/41 (in Italian).
15.
Spielberg F, Branson BM, Goldbaum GM, Lockhart D, Kurth A, Celum CL, Rossini A, Critchlow CW, Wood RW. Overcoming barriers to HIV testing: preferences for new strategies among clients of a needle exchange, a sexually transmitted disease clinic, and sex venues for men who have sex with men. JAIDS Journal of Acquired Immune Deficiency Syndromes. 2003;32:318–28.CrossRefPubMed
16.
Conway DP, Holt M, Couldwell DL, Smith DE, Davies SC, McNulty A, Keen P, Cunningham P, Guy R. Sydney rapid HIV test study. Barriers to HIV testing and characteristics associated with never testing among gay and bisexual men attending sexual health clinics in Sydney. J Int AIDS Soc. 2015;18:20221.CrossRefPubMedPubMedCentral
17.
Suthar AB, Ford N, Bachanas PJ, Wong VJ, Rajan JS, Saltzman AK, Ajose O, Fakoya AO, Granich RM, Negussie EK, Baggaley RC. Towards universal voluntary HIV testing and counselling: a systematic review and meta-analysis of community-based approaches. PLoS Med. 2013;10(8):e1001496.CrossRefPubMedPubMedCentral
18.
Bowles KE, Clark HA, Tai E, Sullivan PS, Song B, Tsang J, Dietz CA, Mir J, Mares-DelGrasso A, Calhoun C, Aguirre D, Emerson C, Heffelfinger JD. Implementing rapid HIV testing in outreach and community settings: results from an advancing HIV prevention demonstration project conducted in seven U.S. cities. Public Health Rep. 2008;123(Suppl 3):78–85.CrossRefPubMedPubMedCentral
19.
Fernández-Balbuena S, de la Fuente L, Hoyos J, Rosales-Statkus ME, Barrio G, Belza MJ. Madrid rapid HIV testing group. Highly visible street-based HIV rapid testing: is it an attractive option for a previously untested population? A cross-sectional study. Sex Transm Infect. 2014;90:112–8.CrossRefPubMed
20.
Fernàndez-López L, Reyes-Urueña J, Agustí C, Kustec T, Klavs T, Casabona C, the COBATEST network group. The COBATEST network: a platform to perform monitoring and evaluation of HIV community-based testing practices in Europe and conduct operational research. AIDS Care. 2016;28(Suppl 1):32–6.CrossRefPubMedPubMedCentral
21.
de la Fuente L, Delgado J, Hoyos J, Belza MJ, Alvarez J, Gutiérrez J, Neira-León M, Suárez M. Madrid rapid HIV testing group. Increasing early diagnosis of HIV through rapid testing in a street outreach program in Spain. AIDS Patient Care STDs. 2009;23:625–9.CrossRefPubMedPubMedCentral
22.
Kakalou E, Papastamopoulos V, Ioannidis P, Papanikolaou K, Georgiou O, Skoutelis A. Early HIV diagnosis through use of rapid diagnosis test (RDT) in the community and direct link to HIV care: a pilot project for vulnerable populations in Athens. Greece J Int AIDS Soc. 2014;17(Suppl 3):19619.CrossRefPubMed
23.
Fernàndez-López L, Folch C, Majó X, Gasulla L, Casabona J. Implementation of rapid HIV and HCV testing within harm reduction programmes for people who inject drugs: a pilot study. AIDS Care. 2016;28:712–6.CrossRefPubMed
24.
Peralta L, Constantine N, Griffin Deeds B, et al. Evaluation of youth preferences for rapid and innovative human immunodeficiency virus antibody tests. Arch Pediatr Adolesc Med. 2001;155:838–43.CrossRefPubMed
25.
Spielberg F, Branson BM, Goldbaum GM, et al. Choosing HIV counselling and testing strategies for outreach settings: a randomized trial. J Acquir Immune Defic Syndr. 2005;38:348–55.PubMed
26.
Louie B, Wong E, Klausner JD, et al. Assessment of rapid tests for detection of human immunodeficiency virus specific antibodies in recently infected individuals. J Clin Microbiol. 2008;46:1494–7.CrossRefPubMedPubMedCentral
27.
28.
Laforgerie E, Boucher B, Ly TD, Maisoneuve L, Izopet J, et al. Sensitivity of 8 CE (European Community)-approved rapid disposable tests for anti-HIV antibody detection during and after seroconversion. J Virol Methods. 2010;165:105–7.CrossRefPubMed
29.
Pant Pai N, Balram B, Shivkumar S, et al. Head-to-head comparison of accuracy of a rapid point-of-care HIV test with oral versus whole-blood specimens: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12:373–80.CrossRefPubMed
30.
Thorton AC, Delpech V, Kall MM, et al. HIV testing in community settings in resource-rich countries: a systematic review of the evidence. HIV Med. 2012;13:416–26.CrossRef
Metadata
Title
HIV rapid testing in community and outreach sites: results of a nationwide demonstration project in Italy
Authors
Paola Scognamiglio
Giacomina Chiaradia
Marta Giovanetti
Emidio Albertini
Antonella Camposeragna
Massimo Farinella
Daniela Lorenzetti
Massimo Oldrini
Laura Rancilio
Anna Caraglia
Francesco Paolo Maraglino
Giuseppe Ippolito
Enrico Girardi
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5680-6

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