Feasibility and acceptability of <scp>HIV</scp> screening through the use of rapid tests by general practitioners in a <scp>B</scp>russels area with a substantial <scp>A</scp>frican community

Gennotte, Anne Françeoise; Semaille, Pascal; Ellis, Corey S.; Necsoi, Coca; Abdulatif, M.; Chellum, N.; Evaldre, C.; Laporte, Frank; Mernier, M.; Ounchif, K.; Gidiuta, D.; Schellens, M.-J.; Clumeck, Nathan

doi:10.1111/hiv.12061

Cited by 16 publications

(25 citation statements)

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“…Novel HIV testing technologies were employed by 40 studies in a wide range of clinical settings to increase testing coverage; the majority utilized rapid testing (n = 36) [18,19,22,24,25,34,36,45,46,[48][49][50]56,57,59,65,75,77,81,83,85,88,89,[99][100][101]107,113,117,129,132,134,137,139,141] while four utilized self-sampling (n = 3) [44,52,102] and self-testing strategies (n = 1) [108]. Two of the four self-sampling studies used oral fluid sampling while the self-test required a blood sample.…”

Section: Testing Provision Strategiesmentioning

confidence: 99%

“…Two of the four self-sampling studies used oral fluid sampling while the self-test required a blood sample. Novel testing approaches were particularly applied to improve testing coverage in HIV risk groups including MSM (n = 9) [44][45][46]52,57,81,85,129,134], migrants (n = 7) [22,45,46,57,85,129,132], and people who use/inject drugs (PWUD/ PWID) (n = 5) [50,57,85,89,129].…”

Section: Testing Provision Strategiesmentioning

confidence: 99%

“…Routine testing was most commonly implemented in hospital departments including emergency departments (n = 15) [20,21,25,35,36,64,69,78,92,93,[115][116][117]137,147], inpatient units (n = 10) [24,43,61,95,98,104,111,125,130,135] and outpatient departments (n = 4) [21,74,113,116]. Similarly, IC testing programmes were predominantly instigated in hospitals (n = 8) [109,114,116,[125][126][127][128]135] and primary care (n = 10) [26,38,47,57,88,110,114,116,127,128]. In contrast, integrated testing for HIV with other infections such as hepatitis B and C and STIs was adopted in diverse settings including prisons (n = 3)…”

Section: Testing Provision Strategiesmentioning

confidence: 99%

“…Results also suggest that rapid testing is acceptable to both groups (patient studies, n = 5; provider studies, n = 6), with providers willing to use rapid tests [24,53,56,57,107] and finding their interpretation easy [50]. Some feasibility studies highlighted that nontraditional health care settings can target populations not previously tested for HIV (n = 4) [18,85,132,145], with the reported percentage of first-time testers in such settings ranging from 51 to 75%.…”

Section: Feasibility and Acceptabilitymentioning

confidence: 99%

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HIV testing strategies employed in health care settings in the European Union/European Economic Area (EU/EEA): evidence from a systematic review

et al. 2019

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Objectives Despite the availability of HIV testing guidelines to facilitate prompt diagnosis, late HIV diagnosis remains high across Europe. The study synthesizes recent evidence on HIV testing strategies adopted in health care settings in the European Union/European Economic Area (EU/EEA). Methods Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed and systematic searches were run in five databases (2010–2017) to identify studies describing HIV testing interventions in health care settings in the EU/EEA. The grey literature was searched for unpublished studies (2014–2017). Two reviewers independently performed study selection, data extraction and critical appraisal. Results One hundred and thirty intervention and/or feasibility studies on HIV testing in health care settings were identified. Interventions included testing provision (n = 94), campaigns (n = 14) and education and training for staff and patients (n = 20). HIV test coverage achieved through testing provision varied: 2.9–94% in primary care compared to 3.9–66% in emergency departments. HIV test positivity was lower in emergency departments (0–1.3%) and antenatal services (0–0.05%) than in other hospital departments (e.g. inpatients: 0–5.3%). Indicator condition testing programmes increased HIV test coverage from 3.9–72% before to 12–85% after their implementation, with most studies reporting a 10–20% increase. There were 51 feasibility and/or acceptability studies that demonstrated that HIV testing interventions were generally acceptable to patients and providers in health care settings (e.g. general practitioner testing acceptable: 77–93%). Conclusions This review has identified several strategies that could be adopted to achieve high HIV testing coverage across a variety of health care settings and populations in the EU/EEA. Very few studies compared the intervention under investigation to a baseline, but, where this was assessed, data suggested increases in testing.

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Section: Testing Provision Strategiesmentioning

confidence: 99%

Section: Testing Provision Strategiesmentioning

confidence: 99%

Section: Testing Provision Strategiesmentioning

confidence: 99%

Section: Feasibility and Acceptabilitymentioning

confidence: 99%

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HIV testing strategies employed in health care settings in the European Union/European Economic Area (EU/EEA): evidence from a systematic review

et al. 2019

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“…Results can be read in less than 1 min. Previous studies of the INSTI HIV-1/HIV-2 antibody test found it to be highly sensitive, specific, and easy to use (5)(6)(7)(8)(9)(10)(11). The INSTI Multiplex assay was developed recently, and no published data on its accuracy, feasibility, or acceptability exist yet.…”

mentioning

confidence: 99%

Laboratory Evaluation of a Point-of-Care Downward-Flow Assay for Simultaneous Detection of Antibodies to Treponema pallidum and Human Immunodeficiency Virus

et al. 2016

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dCombining the detection of syphilis and HIV antibodies into one point-of-care test integrates syphilis screening into already existing HIV screening programs, which may be particularly beneficial in settings such as antenatal care. Using the INSTI Multiplex downward-flow immunoassay, we tested 200 stored serum samples from high-risk patients enrolled in a longitudinal study on HIV infection and syphilis in Peruvian men who have sex with men and transgender women. This rapid assay detected HIV and Treponema pallidum serum antibodies with sensitivities of 100% (95% confidence interval [CI], 95.9% to 100%) and 87.4% (95% CI, 81.4% to 92.0%), respectively, and specificities of 95.5% (95% CI, 89.9% to 98.5%) and 97.0% (95% CI, 84.2% to 99.9%), respectively (n ‫؍‬ 200). The sensitivity for syphilis antibody detection was higher in patients with a rapid plasma reagin titer of >1:8 (97.3%) than in those with a titer of <1:4 (90%) or a nonreactive titer (66.7%). While syphilis, an infection caused by the spirochete Treponema pallidum, is a curable disease, it is estimated that there are 5.6 million new syphilis infections in adults annually (1) compared to approximately 2 million new HIV infections (2). Although new syphilis infections are more common, HIV screening has become a priority in low-and middle-income countries. Syphilis frequently presents atypically, which can make it difficult to clinically differentiate from other sexually transmitted infections; thus, effective diagnostic tests are crucial for correctly identifying and managing syphilis infections (3). Highly accurate diagnostic tests for HIV infection and syphilis exist, but they are often inaccessible to people living in areas with the highest burden of disease. Point-of-care tests provide an opportunity to reach those populations through tests that are inexpensive, easy to perform, and rapid, which enables same-day testing and treatment. Combining the detection of syphilis and HIV antibodies into one point-of-care test integrates syphilis screening into already existing HIV screening programs, which might be particularly beneficial in settings such as antenatal care (4).The INSTI Multiplex downward-flow immunoassay (bioLytical Laboratories, Inc., Canada) is for the simultaneous detection of HIV and T. pallidum antibodies. Results can be read in less than 1 min. Previous studies of the INSTI HIV-1/HIV-2 antibody test found it to be highly sensitive, specific, and easy to use (5-11). The INSTI Multiplex assay was developed recently, and no published data on its accuracy, feasibility, or acceptability exist yet.Using the INSTI Multiplex, we tested 200 stored (Ϫ80°C) serum samples from high-risk patients enrolled in a longitudinal study on HIV infection and syphilis in Peruvian men who have sex with men and transgender women (12). Genital lesions are a sign of primary syphilis, and 14 of the 200 serum samples were from patients who had primary syphilis, confirmed by T. pallidum DNA detection using PCR (12). The sera were tested for HIV and T. pallidum ant...

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HIV testing history and access to treatment among migrants living with HIV in Europe

et al. 2018

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IntroductionMigrants are overrepresented in the European HIV epidemic. We aimed to understand the barriers and facilitators to HIV testing and current treatment and healthcare needs of migrants living with HIV in Europe.MethodsA cross‐sectional study was conducted in 57 HIV clinics in nine countries (Belgium, Germany, Greece, Italy, The Netherlands, Portugal, Spain, Switzerland and United Kingdom), July 2013 to July 2015. HIV‐positive patients were eligible for inclusion if they were as follows: 18 years or older; foreign‐born residents and diagnosed within five years of recruitment. Questionnaires were completed electronically in one of 15 languages and linked to clinical records. Primary outcomes were access to primary care and previous negative HIV test. Data were analysed using random effects logistic regression. Outcomes of interest are presented for women, heterosexual men and gay/bisexual men.ResultsA total of 2093 respondents (658 women, 446 heterosexual men and 989 gay/bisexual men) were included. The prevalence of a previous negative HIV test was 46.7%, 43.4% and 82.0% for women, heterosexual and gay/bisexual men respectively. In multivariable analysis previous testing was positively associated with: receipt of post‐migration antenatal care among women, permanent residency among heterosexual men and identifying as gay rather than bisexual among gay/bisexual men. Access to primary care was found to be high (>83%) in all groups and was strongly associated with country of residence. Late diagnosis was common for women and heterosexual men (60.8% and 67.1%, respectively) despite utilization of health services prior to diagnosis. Across all groups almost three‐quarters of people on antiretrovirals had an HIV viral load <50 copies/mL.ConclusionsMigrants access healthcare in Europe and while many migrants had previously tested for HIV, that they went on to test positive at a later date suggests that opportunities for HIV prevention are being missed. Expansion of testing beyond sexual health and antenatal settings is still required and testing opportunities should be linked with combination prevention measures such as access to PrEP and treatment as prevention.

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Feasibility and acceptability of HIV screening through the use of rapid tests by general practitioners in a Brussels area with a substantial African community

Cited by 16 publications

References 1 publication

HIV testing strategies employed in health care settings in the European Union/European Economic Area (EU/EEA): evidence from a systematic review

HIV testing strategies employed in health care settings in the European Union/European Economic Area (EU/EEA): evidence from a systematic review

Laboratory Evaluation of a Point-of-Care Downward-Flow Assay for Simultaneous Detection of Antibodies to Treponema pallidum and Human Immunodeficiency Virus

HIV testing history and access to treatment among migrants living with HIV in Europe

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