OBJECTIVES: Community HIV testing represents an opportunity for diagnosing HIV infection among individuals who may not have contact with health services, especially in hard-to-reach groups. The aim of this review was to assess the evidence for feasibility, acceptability and effectiveness of HIV testing strategies in community settings in resource-rich countries. METHODS: The PubMed database was searched for English language studies of outreach HIV testing in resource-rich countries. Studies were included if they reported one of the following outcome measures: uptake of testing; seropositivity; client acceptability; or provider acceptability. RESULTS: Forty-four studies were identified; the majority took place in the USA and targeted men who have sex with men. Uptake of HIV testing varied between 9 and 95% (in 14 studies). Seropositivity was ≥ 1% in 30 of 34 studies. In 16 studies the proportion of patients who received their test results varied from 29 to 100% and rapid testing resulted in a higher proportion of clients receiving their results. Overall, client satisfaction with community HIV testing was high. However, concern remained over confidentiality, professional standards and the need for post-test counselling. Staff reported positive attitudes towards community testing. CONCLUSIONS: In the majority of studies, the reported seropositivity was higher than 1/1000, the threshold deemed to be cost-effective for routinely offering testing. Rapid testing improved the return of HIV test results to clients. HIV testing in outreach settings may be important in identifying undiagnosed infections in at-risk populations, but appropriate data to evaluate these initiatives must be collected.
OBJECTIVES: Community HIV testing represents an opportunity for diagnosing HIV infection among individuals who may not have contact with health services, especially in hard-to-reach groups. The aim of this review was to assess the evidence for feasibility, acceptability and effectiveness of HIV testing strategies in community settings in resource-rich countries. METHODS: The PubMed database was searched for English language studies of outreach HIV testing in resource-rich countries. Studies were included if they reported one of the following outcome measures: uptake of testing; seropositivity; client acceptability; or provider acceptability. RESULTS: Forty-four studies were identified; the majority took place in the USA and targeted men who have sex with men. Uptake of HIV testing varied between 9 and 95% (in 14 studies). Seropositivity was ≥ 1% in 30 of 34 studies. In 16 studies the proportion of patients who received their test results varied from 29 to 100% and rapid testing resulted in a higher proportion of clients receiving their results. Overall, client satisfaction with community HIV testing was high. However, concern remained over confidentiality, professional standards and the need for post-test counselling. Staff reported positive attitudes towards community testing. CONCLUSIONS: In the majority of studies, the reported seropositivity was higher than 1/1000, the threshold deemed to be cost-effective for routinely offering testing. Rapid testing improved the return of HIV test results to clients. HIV testing in outreach settings may be important in identifying undiagnosed infections in at-risk populations, but appropriate data to evaluate these initiatives must be collected.
Authors: Carlos Blanco; Melanie M Wall; Wilson M Compton; Shoshana Kahana; Tianshu Feng; Tulshi Saha; Jennifer C Elliott; H Irene Hall; Bridget F Grant Journal: J Psychiatr Res Date: 2018-08-03 Impact factor: 4.791
Authors: Gregg S Gonsalves; Forrest W Crawford; Paul D Cleary; Edward H Kaplan; A David Paltiel Journal: Med Decis Making Date: 2017-07-12 Impact factor: 2.583
Authors: Jessica E Draughon; Jocelyn C Anderson; Bryan R Hansen; Daniel J Sheridan Journal: J Assoc Nurses AIDS Care Date: 2013-10-05 Impact factor: 1.354
Authors: Bohdan Nosyk; Xiao Zang; Emanuel Krebs; Benjamin Enns; Jeong E Min; Czarina N Behrends; Carlos Del Rio; Julia C Dombrowski; Daniel J Feaster; Matthew Golden; Brandon D L Marshall; Shruti H Mehta; Lisa R Metsch; Ankur Pandya; Bruce R Schackman; Steven Shoptaw; Steffanie A Strathdee Journal: Lancet HIV Date: 2020-03-05 Impact factor: 12.767