Implementation of rapid HIV and HCV testing within harm reduction programmes for people who inject drugs: a pilot study

Abstract

To assess acceptability and feasibility of rapid HIV and HCV tests in HRP; to identify HIV and HCV prevalence rates in HRP; to identify the percentage of PWID with a reactive test that attend hospital for confirmation and follow-up. Rapid oral tests for HCV and HIV were offered to users of 13 HRP from both mobile units and facility-based centres. A total of 172 HCV and 198 HIV tests were performed, with a refusal rate of 1.7% and 10.4%, respectively. Injectors made up 64.9% of all drug users and 35.1% did not inject drugs. Overall, 20.3% of HCV tests and 2.5% of HIV test were reactive. Only 24 of the 35 reactive HCV could be confirmed (68.6%) and one was false-negative. Of the five HIV reactive cases, only two could be confirmed (40%) with 1 false-positive case. Acceptability of rapid HIV and HCV tests among HRP users was high. The usefulness of oral rapid tests in HRP has been demonstrated, especially in mobile HRP.

HIV testing strategies outside of health care settings in the European Union (EU)/European Economic Area (EEA): a systematic review to inform European Centre for Disease Prevention and Control guidance

“…Twenty studies provided non‐targeted testing to the general population, while 44 studies provided testing to one or more groups at higher risk of HIV infection. MSM were the group most frequently targeted ( n = 31) , followed by: migrants ( n = 10) , people who use/inject drugs (PWUD/PWID) ( n = 8) , SWs ( n = 7) , black and minority ethnic groups (BME) ( n = 5) , young people ( n = 4) , homeless people ( n = 3) , and other key risk populations not specified ( n = 3) .…”

“…Of the 65 studies that introduced HIV testing, 56 studies utilized novel HIV testing technologies to improve testing uptake [18,19,[21][22][23][25][26][27]29,[31][32][33][34][35][36][37][38][39][41][42][43]46,47,[50][51][52]54,[58][59][60][61][62][64][65][66][67][68][69][72][73][74][75][76][77][78]81,83,84,[86][87][88][89]…”

“…Twelve studies provided HIV self-sampling (oral-fluid sample: n = 7 [32,38,46,59,72,74,77]; blood sample: n = 6 [18,25,32,43,47,94]) and six provided self-testing (oral-fluid: n = 3 [23,42,97]; blood: n = 3 [22,31,75]). Twenty-six studies provided HIV testing as part of an integrated testing programme with: other blood-borne viruses (n = 17) [19,20,26,30,36,39,57,58,65,67,73,78,[85][86][87][88]96], sexually transmitted infections (STIs) (n = 19) [20,26,30,54,[56][57][58]62,63,65,73,76,78,…”

“…Twenty studies provided non-targeted testing to the general population, while 44 studies provided testing to one or more groups at higher risk of HIV infection. MSM were the group most frequently targeted (n = 31) [20,21,[25][26][27]30,32,38,39,46,51,54,58,60,61,[63][64][65][66][72][73][74]76,77,81,86,87,89,94,96,97], followed by: migrants (n = 10) [21,33,52,59,61,74,86,87,89,97], people who use/inject drugs (PWUD/PWID) (n = 8) [33,36,49,61,81,86,87,89], SWs (n = 7)…”

“…The feasibility/acceptability of testing outside of health care settings was assessed by 48 studies (Table 3) [18,[20][21][22][23][24][27][28][29][31][32][33][34]36,37,40,[42][43][44][46][47][48]51,54,59,61,63,65,67,69,[71][72][73][74][75][76][77][78][79][80][81][82][83]85,87,90,93,97]. Overall, HIV testing was found to be acceptable to people offered testing across community (65-99%) [27,…”