ObjectivesWe assessed the efficiency of BCN Checkpoint in detecting new cases of HIV infection and efficiently linking newly diagnosed individuals to care. MethodsThis study analysed during 2007-2012 the number of tests performed and the number of persons tested in BCN Checkpoint, the HIV prevalence, global and in first visits, the capacity of HIV detection compared to the reported cases in MSM in Catalonia, and the linkage to care rate. ResultsDuring the six years a total of 17.319 tests were performed and 618 HIV-positive cases were detected. Median prevalence of clients who visited the centre for the first time was 5.4% (4.1-5.8). BCN Checkpoint detected 36. 3% (35.0-40.4) of all reported cases in MSM during [2009][2010][2011]. Linkage to care was achieved directly in 90.5% of the cases and only 2.4% of cases were lost to follow-up. ConclusionsA community-based centre, addressed to a key population at risk, can be less effort consuming (time and funding) and show high efficiency in HIV detection and linkage to care. . These factors discourage persons from sexual minorities from seeking and receiving essential HIV prevention, testing, care and treatment services, condemning them to remain at disproportionately high risk of HIV acquisition [6]. Greater access to testing and availability of prevention and care services for persons infected with HIV can reduce new infections and lead to reductions in HIV-associated morbidity and mortality [7]. To overcome some of these barriers to the early diagnosis and linkage to care of infected persons, the patient-based organization Projecte dels NOMS-Hispanosida created in 2006 BCN Checkpoint, a community-based centre (CBC) for MSM in the gay area of Barcelona. This centre offers HIV testing free of prejudice, peer counselling and support, and linkage to medical care for people diagnosed with HIV infection. The centre is staffed by a part-time physician, a nurse, 12 counsellors, a receptionist and two administrative assistants. All members of the team are gay, some are HIV positive and six counsellors are part-time volunteers. Peer support is fundamental in helping HIV-infected persons to deal with the emotional impact of receiving such a diagnosis, as well as in helping them to seek medical care and adhere to treatment. This CBC is dedicated to MSM because Barcelona has a significant MSM community with a high prevalence of HIV infection (17%) [8]. Awareness of serostatus also results in a reduction in the risk of transmission of HIV to sex partners, as a substantial proportion of PLWHIV reduce sexual behaviours likely to transmit HIV after discovering that they have HIV infection [9]. Thus, HIV testing represents secondary prevention for people who know their HIV status (reduction of prevalence and severity of the disease) and primary prevention for the community (reduction of HIV incidence). KeywordsProjecte dels NOMS-Hispanosida, in addition to setting up BCN Checkpoint, started promoting regular testing for MSM and implemented for the first time in Spain the rapid HIV t...

Reconsent (n = 27) Received CCM (n = 26)** Withdrawn (with reasons) (n = 1) Voluntary withdrawal of consent Reconsent (n = 15) Received PPP (n = 14)** Withdrawn (with reasons) (n = 0)

The ITACA cohort revealed a high and increasing HIV incidence among MSM, especially important among foreign-born men. The findings underscore the need to implement multilevel interventions for MSM taking into account different types of partners, cultural origins and the exposure to other sexually transmitted infections.

Background The introduction in 2006 of the rapid HIV test by BCN Checkpoint in a non‐clinical setting has been a successful step forwards in the uptake of testing. Nevertheless, HIV serostatus should be reported as HIV positive only when a reactive result has been tested again using a different assay (WHO guidelines 2015). The standard confirmation test has been the Western Blot (WB) test. However confirmation results take around 7 days to come back. Aims This study explores the possibility of Point of Care PCR testing for a same‐day confirmation. Materials and Methods Between March 2015 and September 2016 a POC PCR test (Xpert® HIV‐1 Qual) was performed in parallel to the Western Blot test after a reactive HIV rapid test (Alere Determine™ HIV‐1/2 Ag/Ab Combo and Alere™ HIV Combo). HIV confirmed positive cases received emotional support by peers, were informed and prepared for treatment initiation and rapidly linked to HIV clinic. Results During the study period 11 455 tests were performed to 7163 clients. A total of 249 reactive rapid HIV tests were found. For analysis a total of 33 cases were excluded due to the lack of PCR and/or WB test. Results of comparison of the 216 cases showed 194 concordant positive confirmations and 14 concordant negative results. In three cases PCR was positive and WB negative. In five cases PCR was negative and WB positive. Conclusion The POC PCR assay is easy to use and feasible in a community‐based center. Reducing time for confirmation to 90 min has been possible in 91.2% (197/216) of cases with positive PCR result. In cases of a negative PCR result an additional test (WB, Elisa or PCR quantitative) was needed to distinguish false positive results (6.5%) from viral load results below level of detection (2.3%). Clients expressed satisfaction with same‐day confirmation and less anxiety.

Objective To assess the use of fourth-generation rapid diagnostic tests in identifying acute infection of Human Immunodeficiency Virus (HIV). Methods BCN Checkpoint promotes sexual health among men who have sex with men (MSM), with a focus on diagnosing HIV early, initiating combined antiretroviral treatment (cART) promptly, and recommending regular repeat testing for those who have tested negative. This cross-sectional study included all test results obtained at the centre between 25 March 2016 and 24 March 2019. The Alere™ HIV Combo (now rebranded to Determine™ HIV Ultra, from Abbott) was used to detect p24 antigen (p24 Ag) and/or immunoglobulin M (IgM) and G (IgG) antibodies to HIV-1/HIV-2 (HIV Ab). Rapid polymerase chain reaction (PCR) confirmatory testing and Western blot (WB) were performed for clients with a positive rapid test result. Confirmed HIV cases were promptly referred to the HIV unit for care and cART prescription. Results A total of 12,961 clients attended BCN Checkpoint during the study and 27,298 rapid tests were performed. 450 tests were found to be reactive, of which 430 confirmed as HIV-positive, representing a prevalence of 3.32%. Four confirmed cases (0.93%) were detected as “p24 Ag only”, nine (2.09%) as “both p24 and HIV Ab” and 417 (96.98%) as “HIV Ab only”. The “p24 Ag only” group had a 1-log higher viral load than the other groups and initiated treatment on the following working day. Overall, there were 20 false-positive results (0.07% and 4.44% of total and reactive tests, respectively), of which 10 positive for “p24 Ag only” and 10 for “HIV Ab only”. Conclusions Four Acute HIV Infections (AHI), with very high viral loads, have been detected with the “p24 Ag only” while the HIV Ab were still absent. Referral to the HIV unit and initiation of cART on the following working day contributed to improving persons’ health and to reduce HIV transmission chain.