Integration of community-based testing data into national HIV surveillance in Poland, Serbia and Slovakia within the framework of INTEGRATE project

Abstract

Background Community-based voluntary counselling and testing contributes to early HIV diagnoses among key populations. Testing data from such decentralized services is however often not standardized nor linked to national surveillance systems. This study aimed to support the integration of community testing data into respective national surveillance and monitoring and evaluation systems for those infections. We present results from three national pilots, focused on improved data collection and transfer. Methods Within the Joint Action INTEGRATE different pilot activities were planned and implemented according to the local context. In Slovakia, standardised data collection tools were implemented in three community testing services. The data generated was used to calculate the proposed indicators. In Poland, positive test results from the community testing database were linked to the national case-based surveillance database using confirmatory test number, to improve the completeness of behavioural data in the national database. In Serbia, voluntary counselling and testing forms were improved enabling identification of community-based testing. A system to generate unique client identifiers was initiated in the National registry of HIV cases to monitor linkage to care. Results All three sites were able to estimate most of the agreed indicators. In Slovakia during the study period 675 people were tested for HIV, 410 for hepatitis C and 457 for syphilis, with reactivity rates of 0.4, 2.5 and 1.8%, respectively. For HIV, 66.7% of reactive cases were confirmed and linked to care. In Poland, 28.9% of the community testing sites’ records were linked to the national surveillance database (and accounted for 14.3% of all new diagnoses registered here during 2017–2018). Reactivity rate ranged between 1.9% and 2.1%. In Serbia, 80 persons were tested at community sites, from which two had a reactive HIV test result. By linking unique client identifiers from voluntary counselling and testing and National Registry of HIV cases databases, linkage to care within a two-month period was observed for one of two people with reactive HIV test result. Conclusions Pilot activities in the three countries demonstrate that integration of community-based testing data into surveillance systems is feasible and can help improve national surveillance data by providing key information.

Changes in HIV testing trends in Poland during COVID-19 pandemic

“…Działalność PKD skierowana jest do populacji kluczowych, w tym szczególnie do mężczyzn mających kontakty seksualne z mężczyznami, którzy stanowią około 30% klientów punktów. Dodatkowo, chociaż badania w punktach PKD, stanowią tylko 2,4% wszystkich badań wykonywanych w Polsce, to w punktach diagnozowanych jest około 35% nowych zakażeń rejestrowanych w rutynowym nadzorze nad zakażeniami HIV (4).…”

“…improve the epidemiological assessment of epidemic for HIV, viral hepatitis and sexually transmitted diseases (4). In Poland, these activities concerned the integration of data from the epidemiological surveillance coordinated by the NIPH NIH -NRI with data from the anonymous Voluntary Testing and Counselling (VCT) network collected by the National AIDS Center.…”

“…The VCT activity is particularly promoted in key population, especially among men who have sex with men, who constitute approximately 30% of clients. In addition, although only 2,4% of all tests in Poland are performed in VCT, they diagnose 35% of all new HIV cases registered in HIV national surveillance (4).…”

Trends in Sexual Health of Gay, Bisexual, and Other Men Who Have Sex with Men, and Transgender Individuals: Apps Driven Testing Program for HIV and Other STIs in Barcelona, Spain (2016–2023)

“…Surveillance systems for HIV and STIs must be adaptable to specific settings and available resources. The incorporation of community testing significantly enhances the effectiveness of these systems by providing crucial and timely information [ 12 , 13 ].…”