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Groves AK, Stankard P, Bowler SL, Jamil MS, Gebrekristos LT, Smith PD, Quinn C, Ba NS, Chidarikire T, Nguyen VTT, Baggaley R, Johnson C. A systematic review and meta-analysis of the evidence for community-based HIV testing on men's engagement in the HIV care cascade. Int J STD AIDS 2022; 33:1090-1105. [PMID: 35786140 PMCID: PMC9660288 DOI: 10.1177/09564624221111277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/29/2022] [Accepted: 06/13/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVE Men with HIV are less likely than women to know their status, be on antiretroviral therapy, and be virally suppressed. This review examined men's community-based HIV testing services (CB-HTS) outcomes. DESIGN Systematic review and meta-analysis. METHODS We searched seven databases and conference abstracts through July 2018. We estimated pooled proportions and/or risk ratios (for meta-analyses) for each outcome using random effects models. RESULTS 188 studies met inclusion criteria. Common testing models included targeted outreach (e.g. mobile testing), home-based testing, and testing at stand-alone community sites. Across 25 studies reporting uptake, 81% (CI: 75-86%) of men offered testing accepted it. Uptake was higher among men reached through CB-HTS than facility-based HTS (RR = 1.39; CI: 1.13-1.71). Over 69% (CI: 64-71%) of those tested through CB-HTS were men, across 184 studies. Across studies reporting new HIV-positivity among men (n = 18), 96% were newly diagnosed (CI: 77-100%). Across studies reporting linkage to HIV care (n = 8), 70% (CI: 36-103%) of men were linked to care. Across 57 studies reporting sex-disaggregated data for CB-HTS conducted among key populations, men's uptake was high (80%; CI: 70-88%) and nearly all were newly diagnosed and linked to care (95%; CI: 94-100%; and 94%; CI: 88-100%, respectively). CONCLUSION CB-HTS is an important strategy for reaching undiagnosed men with HIV from the general population and key population groups, particularly using targeted outreach models. When compared to facility-based HIV testing services, men tested through CB-HTS are more likely to uptake testing, and nearly all men who tested positive through CB-HTS were newly diagnosed. Linkage to care may be a challenge following CB-HTS, and greater efforts and research are needed to effectively implement testing strategies that facilitate rapid ART initiation and linkage to prevention services.
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Affiliation(s)
- Allison K Groves
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | | | - Sarah L Bowler
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Muhammad S Jamil
- Department of HIV/AIDS, World Health
Organization, Geneva, Switzerland
| | | | - Patrick D Smith
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Caitlin Quinn
- Department of HIV/AIDS, World Health
Organization, Geneva, Switzerland
| | - Ndoungou Salla Ba
- Department of HIV/AIDS, World Health
Organization, Geneva, Switzerland
| | - Thato Chidarikire
- HIV Prevention Programmes, National Department of
Health, Johannesburg, South Africa
| | | | - Rachel Baggaley
- Department of HIV/AIDS, World Health
Organization, Geneva, Switzerland
| | - Cheryl Johnson
- Department of HIV/AIDS, World Health
Organization, Geneva, Switzerland
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Ferrer L, González V, Martró E, Folch C, Saludes V, Muñoz R, Rodríguez V, Morales A, Meroño M, Morey F, Sanjosé SD, Casabona J. High HIV/STI prevalence among cisgender men and transgender women sex workers attending community-based centres in Barcelona, Spain: The Sweetie Project. Int J STD AIDS 2022; 33:1045-1053. [DOI: 10.1177/09564624221116536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background The aim of this study was to describe the socio-demographics, and the sexual and health-seeking behaviours of cisgender men and transgender women sex workers (M & TWSW) attending community-based organisations (CBOs) in Barcelona, Spain, as well as to estimate the prevalence of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), Chlamydia Trachomatis (CT) and Neisseria gonorrhoeae (NG) among them at different anatomical sites. Methods The Sweetie Project was a community-based cross-sectional study of 147 M & TWSW recruited in two CBOs in Barcelona between 2017 and 2018. A nurse collected biological samples from rectum, pharynx and urethra from the subjects at each CBO and the participants self-completed an epidemiological questionnaire. Results The highest prevalence observed was for HIV infection (25.3%) followed by bacterial STIs (NG 19.2% and CT 10.3%). The most prevalent anatomical site was pharyngeal (17.7%) followed by rectal (13.8%). More than half of participants who had a pharyngeal infection presented an isolated pharyngeal infection (57.7%) and half of those who had a rectal or urethral infection presented an isolated infection respectively. The seroprevalence of HCV and HBV was 2.4% and 34.2% respectively. There was a poor but statistically significant correlation between HIV and rectal CT infection ( r = 0.31), previous exposure to HCV ( r = 0.27) or self-reported STI ( r = 0.23), as well as between previous exposure to HCV and rectal CT ( r = 0.21) or self-reported STI ( r = 0.20). Discussion The Sweetie Project confirms the high burden of HIV and bacterial STIs among a sample of M&TWSW recruited in CBOs and reinforces the need to routinely screen them at all exposed anatomical sites.
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Affiliation(s)
- Laia Ferrer
- Centre for Epidemiological Studies on STI and AIDS of Catalonia, Departament de Salut, Generalitat de Catalunya, Badalona, Spain
- CIBER Epidemiologia y Salud Pública, Madrid, Spain
| | - Victoria González
- Centre for Epidemiological Studies on STI and AIDS of Catalonia, Departament de Salut, Generalitat de Catalunya, Badalona, Spain
- CIBER Epidemiologia y Salud Pública, Madrid, Spain
| | - Elisa Martró
- CIBER Epidemiologia y Salud Pública, Madrid, Spain
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- Germans Trias i Pujol Research Institute, Badalona, Spain
| | - Cinta Folch
- Centre for Epidemiological Studies on STI and AIDS of Catalonia, Departament de Salut, Generalitat de Catalunya, Badalona, Spain
- CIBER Epidemiologia y Salud Pública, Madrid, Spain
| | - Verónica Saludes
- CIBER Epidemiologia y Salud Pública, Madrid, Spain
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- Germans Trias i Pujol Research Institute, Badalona, Spain
| | - Rafael Muñoz
- Centre for Epidemiological Studies on STI and AIDS of Catalonia, Departament de Salut, Generalitat de Catalunya, Badalona, Spain
| | - Vanesa Rodríguez
- CIBER Epidemiologia y Salud Pública, Madrid, Spain
- Cancer Epidemiology Research Programme, Institut Català d’Oncologia, Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Francisca Morey
- Cancer Epidemiology Research Programme, Institut Català d’Oncologia, Hospitalet de Llobregat, Barcelona, Spain
| | - Sílvia de Sanjosé
- CIBER Epidemiologia y Salud Pública, Madrid, Spain
- Cancer Epidemiology Research Programme, Institut Català d’Oncologia, Hospitalet de Llobregat, Barcelona, Spain
| | - Jordi Casabona
- Centre for Epidemiological Studies on STI and AIDS of Catalonia, Departament de Salut, Generalitat de Catalunya, Badalona, Spain
- CIBER Epidemiologia y Salud Pública, Madrid, Spain
- Department of Pediatrics, Obstetrics and Gynecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola), Spain
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Fernàndez-López L, Klavs I, Conway A, Kustec T, Serdt M, Baros S, Staneková DV, Lemsalu L, Wawer I, Wysocki P, Casabona J. Recommendations for collection and integration of community-based testing and linkage to care data into national surveillance, monitoring and evaluation systems for HIV, viral hepatitis and sexually transmitted infections: results from the INTEGRATE Joint Action. BMC Infect Dis 2021; 21:794. [PMID: 34517821 PMCID: PMC8438807 DOI: 10.1186/s12879-021-06499-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND National testing strategy, including monitoring and evaluation, is critical in responding to HIV, sexually transmitted infections, and viral hepatitis. Community-based voluntary counselling and testing contributes to early HIV diagnoses among key populations. Countries providing community-based testing, should integrate some core data on testing and linkage to care in these services into national surveillance and monitoring and evaluation systems. This study aimed to support the integration of community-based voluntary counselling and testing data into respective national surveillance and M&E systems for those infections. METHODS Preliminary consensus on indicators for the integration of community-based voluntary counselling and testing data into respective national surveillance and monitoring and evaluation systems was reached. Pilot studies were conducted in Estonia, Poland, Serbia, Slovakia, Slovenia and Spain. After pilot activities were implemented, the final consensus on indicators was reached. An analysis of the facilitators and barriers faced during pilot studies was conducted to inform the final recommendations for implementation. RESULTS The minimum set of six indicators to be integrated into national surveillance and monitoring and evaluation systems were: number of tests, number of clients tested, reactivity rate for tests and clients, positivity (active infection) rates for tests and clients, linkage to care rates for clients with reactive and/or positive test result, proportion of all new diagnoses in a country with first reactive test result at community-based voluntary counselling and testing service. Seven additional indicators were identified. Each indicator should be disaggregated by key population, sex and age group. A list of 10 recommendations for the collection and integration of community-based voluntary counselling and testing data into national surveillance and monitoring and evaluation systems for HIV, sexually transmitted infections and viral hepatitis was identified. CONCLUSIONS Integration of some community-based voluntary counselling and testing monitoring and evaluation data into national surveillance and monitoring and evaluation systems in all pilot countries was achieved. The recommendations will support such integration in other European countries. European Centre for Prevention and Control of Diseases included questions from the minimum list of indicators into their Dublin Declaration questionnaire 2020 to contribute to evidence based community testing policies in European countries.
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Affiliation(s)
- Laura Fernàndez-López
- Health Department, Generalitat de Catalunya, Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Badalona, Spain.
- Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain.
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.
| | - Irena Klavs
- National Institute of Public Health, Trubarjeva 2, Ljubljana, Slovenia
| | - Anna Conway
- Health Department, Generalitat de Catalunya, Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Badalona, Spain
- Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Tanja Kustec
- National Institute of Public Health, Trubarjeva 2, Ljubljana, Slovenia
| | - Mojca Serdt
- National Institute of Public Health, Trubarjeva 2, Ljubljana, Slovenia
| | - Sladjana Baros
- Institute of Public Health of Serbia "Dr Milan Jovanovic Batut", Belgrade, Serbia
| | | | - Liis Lemsalu
- Department of Drug and Infectious Diseases Epidemiology, National Institute for Health Development, Tallinn, Estonia
| | - Iwona Wawer
- National AIDS Centre, The Agency of the Ministry of Health, Warsaw, Poland
| | - Piotr Wysocki
- National AIDS Centre, The Agency of the Ministry of Health, Warsaw, Poland
| | - Jordi Casabona
- Health Department, Generalitat de Catalunya, Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Badalona, Spain
- Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynecology and Preventive Medicine, Univ Autonoma de Barcelona, Badalona, Spain
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Conway A, Fernàndez-López L, Reyes-Urueña J, Casabona J. Hepatitis C Screening in Community-Based Voluntary Counselling and Testing Services in Europe: An Observational Study from the COBATEST Network 2014-2018. J Community Health 2021; 45:606-614. [PMID: 31749115 PMCID: PMC7095007 DOI: 10.1007/s10900-019-00780-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The COBATEST Network links community-based voluntary counselling and testing (CBVCT) services in the European region and collects testing data using standardised data collection tools. This study aims to describe the population being screened for anti-HCV antibodies in the COBATEST Network and identify risk factors associated with a reactive HCV screening test result in the period 2014-2018. Clients aged > 16 screened for HCV in the period 2014-2018 at one of the Network's CBVCT services were included in the study. In the 5 year period, 7426 clients were screened for HCV in 22 centres in 10 countries and anti-HCV antibodies were detected in 113 (1.5%). The majority of people screened were aged 25-44, men who have sex with men (MSM), not HIV+ , not reporting a history of injecting drug use or sex work. Detection of anti-HCV antibodies was associated with being HIV + MSM (aOR 9.1, 95% CI 3.8; 21.8 compared to HIV-clients) and being a person who injects drugs (PWID, aOR 28.1, 95% CI 17.6; 45.0, compared to people with no history of injecting drug use). This study demonstrates that HIV-MSM with no history of injection drug use are using CBVCT services for HCV screening, but reactive screening test is associated with being HIV+ or PWID. The integration of HCV screening into the CBVCT service model may widen access to testing for populations that may otherwise not be tested.
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Affiliation(s)
- Anna Conway
- Generalitat de Catalunya Departament de Salut, Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT), Barcelona, Catalunya, Spain. .,L'Institut de Recerca en Ciències de la Salut Germans Trias i Pujol, Badalona, Catalonia, Spain.
| | - Laura Fernàndez-López
- Generalitat de Catalunya Departament de Salut, Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT), Barcelona, Catalunya, Spain.,L'Institut de Recerca en Ciències de la Salut Germans Trias i Pujol, Badalona, Catalonia, Spain.,CIBERESP, CIBER Epidemiologia y Salud Publica, Barcelona, Catalunya, Spain
| | - Juliana Reyes-Urueña
- Generalitat de Catalunya Departament de Salut, Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT), Barcelona, Catalunya, Spain.,L'Institut de Recerca en Ciències de la Salut Germans Trias i Pujol, Badalona, Catalonia, Spain
| | - Jordi Casabona
- Generalitat de Catalunya Departament de Salut, Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT), Barcelona, Catalunya, Spain.,L'Institut de Recerca en Ciències de la Salut Germans Trias i Pujol, Badalona, Catalonia, Spain.,CIBERESP, CIBER Epidemiologia y Salud Publica, Barcelona, Catalunya, Spain.,Department of Paediatrics, Obstetrics and Gynecology and Preventive Medicine, Universitat Autonoma de Barcelona, Barcelona, Catalunya, Spain
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5
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Fernàndez-López L, Reyes-Urueña J, Conway A, Saz J, Morales A, Quezadas J, Baroja J, Rafel A, Pazos A, Avellaneda A, Meroño M, Andreo L, Romero L, Lara A, Otón A, Rifà B, Mansilla R, Colom J, Casabona J. The contribution of HIV point-of-care tests in early HIV diagnosis: community-based HIV testing monitoring in Catalonia, 1995 to 2018. ACTA ACUST UNITED AC 2021; 25. [PMID: 33124552 PMCID: PMC7596919 DOI: 10.2807/1560-7917.es.2020.25.43.1900424] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Community-based HIV testing services combined with the use of point-of-care tests (POCT) have the potential to improve early diagnosis through increasing availability, accessibility and uptake of HIV testing. Aim To describe community-based HIV testing activity in Catalonia, Spain, from 1995 to 2018, and to evaluate the impact of HIV POCT on the HIV continuum of care. Methods A community-based network of voluntary counselling and testing services in Catalonia, Spain has been collecting systematic data on activity, process and results since 1995. A descriptive analysis was performed on pooled data, describing the data in terms of people tested and reactive screening test results. Results Between 1995 and 2018, 125,876 HIV tests were performed (2.1% reactive). Since the introduction of HIV POCT in 2007, a large increase in the number of tests performed was observed, reaching 14,537 tests alone in 2018 (1.3% reactive). Men who have sex with men (MSM), as a proportion of all people tested, has increased greatly over time reaching 74.7% in 2018. The highest percentage of reactive tests was found in people who inject drugs followed by MSM. The contribution of community-based HIV testing to the overall total notified cases in the Catalonia HIV registry has gradually increased, reaching 37.9% in 2018, and 70% of all MSM cases. In 2018, the percentage of individuals with a reactive screening test who were linked to care was 89.0%. Conclusion Our study reinforces the important role that community-based HIV POCT has on the diagnosis of HIV in key populations.
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Affiliation(s)
- Laura Fernàndez-López
- Centros de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Spain.,Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Catalan Health Department, Barcelona, Spain
| | - Juliana Reyes-Urueña
- Centros de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Spain.,Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Catalan Health Department, Barcelona, Spain
| | - Anna Conway
- The Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain.,Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Catalan Health Department, Barcelona, Spain
| | | | | | - Jaime Quezadas
- Associació Ciutadana Antisida de Catalunya (ACASC), Barcelona, Spain
| | - Jordi Baroja
- Centre Jove d'Atenció a les Sexualitats (CJAS), Barcelona, Spain
| | - Anna Rafel
- Associació Antisida de Lleida, Lleida, Spain
| | | | | | | | - Lorena Andreo
- CAS/ARD Lluís Companys, Creu Roja Barcelona, Barcelona, Spain
| | - Lluís Romero
- Assexora'Tgn (Associacio Comunitària de Salut Sexual del Camp de Tarragona), Tarragona, Spain
| | - Anna Lara
- Associació Comunitària Anti Sida de Girona (ACAS), Girona, Spain
| | | | - Benet Rifà
- Programme for Prevention, Control and Treatment of HIV, STIs and Viral Hepatitis, Public Health Agency of Catalonia, Barcelona, Spain.,Section for Surveillance, Prevention and Control of Sexually Transmitted Infections and HIV, Public Health Agency of Catalonia, Barcelona, Spain
| | - Rosa Mansilla
- Programme for Prevention, Control and Treatment of HIV, STIs and Viral Hepatitis, Public Health Agency of Catalonia, Barcelona, Spain.,Section for Surveillance, Prevention and Control of Sexually Transmitted Infections and HIV, Public Health Agency of Catalonia, Barcelona, Spain
| | - Joan Colom
- Programme for Prevention, Control and Treatment of HIV, STIs and Viral Hepatitis, Public Health Agency of Catalonia, Barcelona, Spain
| | - Jordi Casabona
- Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Centros de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Spain.,Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Catalan Health Department, Barcelona, Spain
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Lorente N, Sherriff N, Panochenko O, Marcus U, Dutarte M, Kuske M, Aussó S, Huber J, Krone M, Schink SB, Cawley C, Casabona J, Folch C. The Role of Community Health Workers Within the Continuum of Services for HIV, Viral Hepatitis, and Other STIs Amongst Men Who Have Sex with Men in Europe. J Community Health 2020; 46:545-556. [PMID: 32737744 PMCID: PMC7393028 DOI: 10.1007/s10900-020-00900-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Little is known about Community Health Workers (CHWs) who work in non-clinical settings to provide sexual health support around HIV, viral hepatitis, and other sexually transmitted infections (STIs) to men who have sex with men (MSM) in Europe and neighbouring countries. This article describes for the first time, who CHWs are, and how they contribute to the continuum of services for HIV, viral hepatitis, and other STIs amongst MSM. The first European Community Health Worker Online Survey (ECHOES) developed in the framework of the EU-funded ESTICOM project (www.esticom.eu), was available in 16 languages (October 2017-January 2018). Amongst the 1035 persons aged 18 and older reporting CHW activities in the previous 12 months, 28.2% were women, 30.7% were volunteers, 59.2% were men self-defining as gay/homosexual, bisexual or queer (‘peer CHWs’), and most CHWs worked/volunteered in private not-for-profit organisations (86.4%). CHWs involvement in the continuum of services for HIV, viral hepatitis and other STIs was as follows: primary prevention (88.6%), consultation and counselling (58.0%), testing provision (50.6%), linkage to care (49.8%), and treatment and support activities (51.3%). CHWs were also involved in cross-cutting activities such as developing interventions, advocacy, and engaging in research (46.3%). CHWs as a public health workforce contribute to all steps of the continuum of services for HIV, viral hepatitis, and other STIs amongst MSM in Europe. National governments should recognise and support CHWs better in order to make their activities more visible and sustainable, and increase their impact on the continuum of services.
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Affiliation(s)
- Nicolas Lorente
- Centre Estudis Epidemiològics Sobre Les Infeccions de Transmissió Sexual I Sida de Catalunya (CEEISCAT), Agència de Salut Pública de Catalunya, 08916, Badalona (Barcelona), Spain.
- Institut Investigació Germans Trias I Pujol (IGTP), 08916, Badalona (Barcelona), Spain.
- Centre D'Estudis Epidemiològics Sobre Les ITS I Sida de Catalunya (CEEISCAT), Fundació Institut D'Investigació en Ciències de La Salut Germans Trias I Pujol (IGTP), Edifici Muntanya, Carretera de Can Ruti, Camí de les Escoles s/n, 08916, Badalona, Barcelona, Spain.
| | - Nigel Sherriff
- School of Health Sciences, and Centre for Transforming Sexuality & Gender, University of Brighton, Brighton, BN1 9PH, UK
| | | | | | - Maria Dutarte
- European AIDS Treatment Group (EATG), 1000, Brussels, Belgium
- European Patients' Forum (EPF), 1040, Brussels, Belgium
| | | | - Susanna Aussó
- Centre Estudis Epidemiològics Sobre Les Infeccions de Transmissió Sexual I Sida de Catalunya (CEEISCAT), Agència de Salut Pública de Catalunya, 08916, Badalona (Barcelona), Spain
- Institut Investigació Germans Trias I Pujol (IGTP), 08916, Badalona (Barcelona), Spain
| | - Jörg Huber
- School of Health Sciences, and Centre for Transforming Sexuality & Gender, University of Brighton, Brighton, BN1 9PH, UK
| | | | | | | | - Jordi Casabona
- Centre Estudis Epidemiològics Sobre Les Infeccions de Transmissió Sexual I Sida de Catalunya (CEEISCAT), Agència de Salut Pública de Catalunya, 08916, Badalona (Barcelona), Spain
- Institut Investigació Germans Trias I Pujol (IGTP), 08916, Badalona (Barcelona), Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), 28029, Madrid, Spain
- Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva, Universitat Autònoma de Barcelona, 08916, Badalona (Barcelona), Spain
| | - Cinta Folch
- Centre Estudis Epidemiològics Sobre Les Infeccions de Transmissió Sexual I Sida de Catalunya (CEEISCAT), Agència de Salut Pública de Catalunya, 08916, Badalona (Barcelona), Spain
- Institut Investigació Germans Trias I Pujol (IGTP), 08916, Badalona (Barcelona), Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), 28029, Madrid, Spain
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Regine V, Dorrucci M, Pezzotti P, Mammone A, Quinten C, Pharris A, Suligoi B, The Regional Representatives Of The National Hiv Surveillance System. People living with undiagnosed HIV infection and a low CD4 count: estimates from surveillance data, Italy, 2012 to 2014. ACTA ACUST UNITED AC 2019; 23. [PMID: 29667577 PMCID: PMC6836199 DOI: 10.2807/1560-7917.es.2018.23.15.17-00240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background and aims Late HIV diagnosis is associated with onward HIV transmission, higher morbidity, mortality and healthcare costs. In Italy, more than half of people living with HIV were diagnosed late during the last decade, with a CD4 count < 350 cells/mm3 at diagnosis. We aimed to determine the number and characteristics of people living with undiagnosed HIV infection and low CD4 counts in Italy. Methods Data on newly reported HIV diagnoses from 2012 –2014 were obtained from the national HIV surveillance system. We used the European Centre for Disease Prevention and Control HIV modelling tool to calculate the undiagnosed prevalence and yearly diagnosed fraction (YDF) in people with low CD4 count. Results The estimated annual number undiagnosed HIV infections with low CD4 count was on average 6,028 (95% confidence interval (CI): 4,954–8,043) from 2012–2014. In 2014, most of the undiagnosed people with low CD4 count were men (82.8%), a third acquired HIV through sex between men (MSM) (35.0%), and heterosexual transmission (33.4%), respectively. The prevalence of undiagnosed HIV infection was 11.3 (95% CI: 9.3–14.9) per 100,000 residents ranging from 0.7 to 20.8 between Italian regions. Nationally the prevalence rate was 280.4 (95% CI: 173.3–450.2) per 100,000 MSM, 8.3 (95% CI: 4.9–13.6) per 100,000 heterosexual men, and 3.0 (95% CI: 1.4–5.6) per 100,000 women. The YDF was highest among heterosexual women (27.1%; 95% CI: 16.9–45.2%). Conclusions These findings highlight the importance of improving efforts to identify undiagnosed HIV infections primarily among men, both MSM and heterosexual men.
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Affiliation(s)
- Vincenza Regine
- Infectious Diseases Department, Italian National Institute of Health, Rome, Italy
| | - Maria Dorrucci
- Infectious Diseases Department, Italian National Institute of Health, Rome, Italy
| | - Patrizio Pezzotti
- Infectious Diseases Department, Italian National Institute of Health, Rome, Italy
| | - Alessia Mammone
- National Institute for Infectious Diseases 'L. Spallanzani', Rome, Italy
| | - Chantal Quinten
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Anastasia Pharris
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Barbara Suligoi
- Infectious Diseases Department, Italian National Institute of Health, Rome, Italy
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Rojas Castro D, Delabre RM, Morel S, Michels D, Spire B. Community engagement in the provision of culturally competent HIV and STI prevention services: lessons from the French experience in the era of PrEP. J Int AIDS Soc 2019; 22 Suppl 6:e25350. [PMID: 31468710 PMCID: PMC6715944 DOI: 10.1002/jia2.25350] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 06/24/2019] [Indexed: 12/27/2022] Open
Affiliation(s)
- Daniela Rojas Castro
- Coalition PLUS, Community-Based Research Laboratory, Pantin, France.,Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
| | | | - Stéphane Morel
- Coalition PLUS, Community-Based Research Laboratory, Pantin, France.,AIDES, Pantin, France
| | - David Michels
- Coalition PLUS, Community-Based Research Laboratory, Pantin, France.,AIDES, Pantin, France
| | - Bruno Spire
- Coalition PLUS, Community-Based Research Laboratory, Pantin, France.,Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.,AIDES, Pantin, France
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9
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Fernàndez-López L, Reyes-Urueña J, Agustí C, Kustec T, Serdt M, Klavs I, Casabona J. The COBATEST network: monitoring and evaluation of HIV community-based practices in Europe, 2014-2016. HIV Med 2019; 19 Suppl 1:21-26. [PMID: 29488701 DOI: 10.1111/hiv.12592] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this paper is to describe the data collected by the CBVCT services from the Community-based testing (COBATEST) network, from 2014 to 2016, in order to provide an insight into community-based voluntary counselling and testing (CBVCT) services' testing activity in Europe. METHODS A descriptive analysis of HIV testing activity in CBVCT services that are using the COBATEST tools was performed for the period 2014-2016. RESULTS During the study period, a total of 30 329 HIV tests were performed on 27 934 individuals, of which 1.8% were reactive. Of these reactive tests, 75.8% had a confirmatory test, 92.2% of those were confirmed as positive, and 90.38% of the confirmed positives were linked to care. The total number of tests performed over the study period increased 19.31%. The proportion of confirmatory tests increased from 63.0% to 90.0% and proportion linked to care increased from 84.1% to 93.8%. Most of the tested individuals were men (70.6%), aged between 21 and 35 years (58.5%) and non-foreign born (68.1%). A high proportion of individuals tested were men who have sex with men (MSM; 42.2%). The percentage of reactive screening tests was particularly high among transgender people (8.37%) and among male sex workers (6.38%). Repeat testers had a higher percentage of reactive tests (2.02%) than those tested for first time (1.1%). CONCLUSIONS These results prove the feasibility of collecting standardized data from CBVCT services in different countries across Europe and demonstrate the usefulness of such data.
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Affiliation(s)
- L Fernàndez-López
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Badalona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - J Reyes-Urueña
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Badalona, Spain
| | - C Agustí
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Badalona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - T Kustec
- National Institute of Public Health, Ljubljana, Slovenia
| | - M Serdt
- National Institute of Public Health, Ljubljana, Slovenia
| | - I Klavs
- National Institute of Public Health, Ljubljana, Slovenia
| | - J Casabona
- Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Badalona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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10
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Scognamiglio P, Chiaradia G, Giovanetti M, Albertini E, Camposeragna A, Farinella M, Lorenzetti D, Oldrini M, Rancilio L, Caraglia A, Maraglino FP, Ippolito G, Girardi E. HIV rapid testing in community and outreach sites: results of a nationwide demonstration project in Italy. BMC Public Health 2018; 18:748. [PMID: 29914449 PMCID: PMC6006581 DOI: 10.1186/s12889-018-5680-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 06/07/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Globally the access to HIV testing has greatly increased over the past 30 years. Nonetheless, a high proportion of people living with HIV remains undiagnosed, even in resource rich countries. To increase the proportion of people aware of their HIV serostatus and their access to medical care, several strategies have been proposed including HIV rapid test programs offered outside health facilities. The aim of this project was to evaluate the feasibility and efficacy of the HIV rapid testing offered in community and outreach settings in Italy. METHODS We conducted a national demonstration project on HIV rapid tests offered in community and outreach settings, including nongovernmental organization (NGO) facilities, primary care services for migrants and low-threshold services or mobile units for drug users (DU services). HIV rapid test on oral fluid (OraQuick®; Orasure Technologies) was anonymously offered to eligible people who presented themselves at the selected sites. Those with reactive results were referred to a specialized outpatient unit for confirmatory testing and medical care. RESULTS Over a period of six months a total of 2949 tests were performed and 45.2% of individuals tested had not been previously tested. Overall 0.9% (27/2949) of tested people had a preliminary positive test. In NGO facilities the positivity rate was 1%. All subjects who performed their confirmatory test were confirmed as positive. In services for migrants the positivity rate was 0.5 and 80% were referred to care (with 1 false positive test). In DU services we observed the highest positivity rate (1.4%) but the lowest linkage to care (67%), with 1 false positive test. CONCLUSION Our project showed that the offering of an HIV rapid testing program in community and outreach settings in Italy is feasible and that it may reach people who have never been tested before, while having a significant yield in terms of new HIV diagnoses as well.
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Affiliation(s)
- Paola Scognamiglio
- Clinical Epidemiology Unit - Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases "L. Spallanzani", IRCCS, Via Portuense 292, 00149, Rome, Italy
| | - Giacomina Chiaradia
- Clinical Epidemiology Unit - Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases "L. Spallanzani", IRCCS, Via Portuense 292, 00149, Rome, Italy.
| | - Marta Giovanetti
- Clinical Epidemiology Unit - Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases "L. Spallanzani", IRCCS, Via Portuense 292, 00149, Rome, Italy
| | - Emidio Albertini
- Onphalos LGBTI (Lesbian, Gay, Bisexual, Transgender/Transsexual and Intersexed), Perugia, Italy
| | | | | | - Daniela Lorenzetti
- ANLAIDS Onlus - Italian National Association for the fight against Aids, Rome, Italy
| | - Massimo Oldrini
- Lila Onlus - Italian League for the Fight against AIDS, Milan, Italy
| | - Laura Rancilio
- Caritas Ambrosiana, AIDS, Addictions and Mental Health Area, Milan, Italy
| | - Anna Caraglia
- Directorate-general for Health Prevention, Infectious Diseases Office, Ministry of Health, Rome, Italy
| | - Francesco Paolo Maraglino
- Directorate-general for Health Prevention, Infectious Diseases Office, Ministry of Health, Rome, Italy
| | - Giuseppe Ippolito
- Clinical Epidemiology Unit - Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases "L. Spallanzani", IRCCS, Via Portuense 292, 00149, Rome, Italy
| | - Enrico Girardi
- Clinical Epidemiology Unit - Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases "L. Spallanzani", IRCCS, Via Portuense 292, 00149, Rome, Italy
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11
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Sullivan AK, Sperle I, Raben D, Amato-Gauci AJ, Lundgren JD, Yazdanpanah Y, Jakobsen SF, Tavoschi L. HIV testing in Europe: Evaluating the impact, added value, relevance and usability of the European Centre for Disease Prevention and Control (ECDC)'s 2010 HIV testing guidance. ACTA ACUST UNITED AC 2018; 22. [PMID: 29208158 PMCID: PMC5725791 DOI: 10.2807/1560-7917.es.2017.22.48.17-00323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: An evaluation of the 2010 ECDC guidance on HIV testing, conducted in October 2015–January 2016, assessed its impact, added value, relevance and usability and the need for updated guidance. Methods: Data sources were two surveys: one for the primary target audience (health policymakers and decision makers, national programme managers and ECDC official contact points in the European Union/European Economic Area (EU/EEA) countries and one for a broader target audience (clinicians, civil society organisations and international public health agencies); two moderated focus group discussions (17 participants each); webpage access data; a literature citation review; and an expert consultation (18 participants) to discuss the evaluation findings. Results: Twenty-three of 28 primary target audience and 31 of 51 broader target audience respondents indicated the guidance was the most relevant when compared with other international guidance. Primary target audience respondents in 11 of 23 countries reported that they had used the guidance in development, monitoring and/or evaluation of their national HIV testing policy, guidelines, programme and/or strategy, and 29 of 51 of the broader target audience respondents reported having used the guidance in their work. Both the primary and broader target audience considered it important or very important to have an EU/EEA-level HIV testing guidance (23/28 and 46/51, respectively). Conclusion: The guidance has been widely used to develop policies, guidelines, programmes and strategies in the EU/EEA and should be regularly updated due to continuous developments in the field in order to continue to serve as an important reference guidance in the region.
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Affiliation(s)
- Ann K Sullivan
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Ida Sperle
- CHIP, Rigshospitalet, University of Copenhagen, Denmark
| | - Dorthe Raben
- CHIP, Rigshospitalet, University of Copenhagen, Denmark
| | | | | | | | | | - Lara Tavoschi
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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12
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Croxford S, Yin Z, Burns F, Copas A, Town K, Desai S, Skingsley A, Delpech V. Linkage to HIV care following diagnosis in the WHO European Region: A systematic review and meta-analysis, 2006-2017. PLoS One 2018; 13:e0192403. [PMID: 29451875 PMCID: PMC5815583 DOI: 10.1371/journal.pone.0192403] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 01/22/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Timely linkage to care after HIV diagnosis is crucial as delayed access can result in poor patient outcomes. The aim of this systematic review was to synthesise the evidence to achieve a better understanding of what proportion of patients are linked to care and what factors impact linkage. METHODS Systematic searches were run in six databases up to the end of February 2017. The grey literature was also reviewed. Inclusion criteria were: sample size ≥50 people (aged ≥15), from the WHO European Region, published 2006-2017 and in English. Linkage to care was defined as a patient seen for HIV care after diagnosis. Study selection, data extraction and quality assurance were performed by two independent reviewers. Random-effects meta-analysis was carried out to summarise linkage to care within three months of diagnosis. RESULTS Twenty-four studies were included; 22 presented linkage to care data and seven examined factors for linkage. Linkage among 89,006 people in 19 countries was captured. Meta-analysis, restricted to 12 studies and measuring prompt linkage within three months, gave a pooled estimate of 85% (95% CI: 75%-93%). Prompt linkage was higher in studies including only people in care (94%; 95% CI: 91%-97%) than in those of all new diagnoses (71%; 95% CI: 50%-87%). Heterogeneity was high across and within strata (>99%). Factors associated with delaying or not linking to care included: acquiring HIV through heterosexual contact/injecting drug use, younger age at diagnosis, lower levels of education, feeling well at diagnosis and diagnosis outside an STI clinic. CONCLUSION Overall, linkage to care was high, though estimates were lower in studies with a high proportion of people who inject drugs. The high heterogeneity between studies made it challenging to synthesise findings. Studies should adopt a standardised definition with a three month cut-off to measure prompt linkage to care to ensure comparability.
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Affiliation(s)
- Sara Croxford
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom
- Centre for Population Research in Sexual Health and HIV, Institute of Global Health, University College London, London, United Kingdom
| | - Zheng Yin
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom
| | - Fiona Burns
- Centre for Population Research in Sexual Health and HIV, Institute of Global Health, University College London, London, United Kingdom
- Royal Free London NHS Foundation Trust, London United Kingdom
| | - Andrew Copas
- Centre for Population Research in Sexual Health and HIV, Institute of Global Health, University College London, London, United Kingdom
| | - Katy Town
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom
- Centre for Population Research in Sexual Health and HIV, Institute of Global Health, University College London, London, United Kingdom
| | - Sarika Desai
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom
| | - Andrew Skingsley
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom
| | - Valerie Delpech
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, United Kingdom
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13
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Tavoschi L, Hales D. Monitoring of HIV testing services in the EU/EEA. ACTA ACUST UNITED AC 2017; 21:30410. [PMID: 27934584 PMCID: PMC5388108 DOI: 10.2807/1560-7917.es.2016.21.48.30410] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 11/29/2016] [Indexed: 11/20/2022]
Affiliation(s)
- Lara Tavoschi
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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14
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Perelman J, Rosado R, Amri O, Morel S, Rojas Castro D, Chanos S, Cigan B, Lobnik M, Fuertes R, Pichon F, Kaye PS, Agustí C, Fernàndez-López L, Lorente N, Casabona J. Economic evaluation of HIV testing for men who have sex with men in community-based organizations - results from six European cities. AIDS Care 2016; 29:985-989. [PMID: 28027661 DOI: 10.1080/09540121.2016.1271392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The non-decreasing incidence of HIV among men who have sex with men (MSM) has motivated the emergence of Community Based Voluntary Counselling and Testing (CBVCT) services specifically addressed to MSM. The CBVCT services are characterized by facilitated access and linkage to care, a staff largely constituted by voluntary peers, and private not-for-profit structures outside the formal health system institutions. Encouraging results have been measured about their effectiveness, but these favourable results may have been obtained at high costs, questioning the opportunity to expand the experience. We performed an economic evaluation of HIV testing for MSM at CBVCT services, and compared them across six European cities. We collected retrospective data for six CBVCT services from six cities (Copenhagen, Paris, Lyon, Athens, Lisbon, and Ljubljana), for the year 2014, on the number of HIV tests and HIV reactive tests, and on all expenditures to perform the testing activities. The total costs of CBVCTs varied from 54,390€ per year (Ljubljana) to 245,803€ per year (Athens). The cost per HIV test varied from to 41€ (Athens) to 113€ (Ljubljana). The cost per HIV reactive test varied from 1966€ (Athens) to 9065€ (Ljubljana). Our results show that the benefits of CBVCT services are obtained at an acceptable cost, in comparison with the literature (values, mostly from the USA, range from 1600$ to 16,985$ per HIV reactive test in clinical and non-clinical settings). This result was transversal to several European cities, highlighting that there is a common CBVCT model, the cost of which is comparable regardless of the epidemiological context and prices. The CBVCT services represent an effective and "worth it" experience, to be continued and expanded in future public health strategies towards HIV.
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Affiliation(s)
- Julian Perelman
- a Escola Nacional de Saúde Pública , Universidade NOVA de Lisboa , Lisbon , Portugal.,b Centro de Investigação em Saúde Pública , Lisbon , Portugal
| | - Ricardo Rosado
- a Escola Nacional de Saúde Pública , Universidade NOVA de Lisboa , Lisbon , Portugal
| | | | | | | | | | - Bojan Cigan
- e Drustvo informacijski center Legebitra , Ljubljana , Slovenia
| | - Miha Lobnik
- e Drustvo informacijski center Legebitra , Ljubljana , Slovenia
| | | | | | | | - Cristina Agustí
- h Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT) , Departament de Salut, Generalitat de Catalunya , Badalona , Spain.,i Hospital Germans trias i Pujol , Barcelona , Spain.,j The Institute for Health Science Research Germans Trias i Pujol (IGTP) , Badalona , Spain.,k CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
| | - Laura Fernàndez-López
- h Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT) , Departament de Salut, Generalitat de Catalunya , Badalona , Spain.,i Hospital Germans trias i Pujol , Barcelona , Spain.,j The Institute for Health Science Research Germans Trias i Pujol (IGTP) , Badalona , Spain.,k CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
| | - Nicolas Lorente
- h Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT) , Departament de Salut, Generalitat de Catalunya , Badalona , Spain.,i Hospital Germans trias i Pujol , Barcelona , Spain.,j The Institute for Health Science Research Germans Trias i Pujol (IGTP) , Badalona , Spain
| | - Jordi Casabona
- h Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT) , Departament de Salut, Generalitat de Catalunya , Badalona , Spain.,i Hospital Germans trias i Pujol , Barcelona , Spain.,j The Institute for Health Science Research Germans Trias i Pujol (IGTP) , Badalona , Spain.,k CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
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15
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Lorente N, Fernàndez-López L, Fuertes R, Rojas Castro D, Pichon F, Cigan B, Chanos S, Meireles P, Lucas R, Morel S, Slaaen Kaye P, Agustí C, Klavs I, Platteau T, Casabona J. COBA-Cohort: a prospective cohort of HIV-negative men who have sex with men, attending community-based HIV testing services in five European countries (a study protocol). BMJ Open 2016; 6:e011314. [PMID: 27412103 PMCID: PMC4947773 DOI: 10.1136/bmjopen-2016-011314] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Community-based voluntary counselling and testing (CBVCT) services for men who have sex with men (MSM) can reach those most-at-risk and provide an environment for gay men that is likely to be non-stigmatising. Longitudinal data on the behaviour of HIV-negative MSM are scarce in Europe. The aim of this protocol, developed during the Euro HIV Early Diagnosis And Treatment (EDAT) project, is to implement a multicentre community-based cohort of HIV-negative MSM attending 15 CBVCT services in 5 European countries. RESEARCH OBJECTIVES (1) To describe the patterns of CBVCT use, (2) to estimate HIV incidence, and to identify determinants of (3) HIV seroconversion and (4) HIV and/or sexually transmitted infection (STI) test-seeking behaviour. METHODS AND ANALYSIS All MSM aged 18 years or over and who had a negative HIV test result are invited to participate in the COmmunity-BAsed Cohort (COBA-Cohort). Study enrolment started in February 2015, and is due to continue for at least 12 months at each study site. Follow-up frequency depends on the testing recommendations in each country (at least 1 test per year). Sociodemographic data are collected at baseline; baseline and follow-up questionnaires both gather data on attitudes and perceptions, discrimination, HIV/STI testing history, sexual behaviour, condom use, and pre- and post-exposure prophylaxis. Descriptive, exploratory and multivariate analyses will be performed to address the main research objectives of this study, using appropriate statistical tests and models. These analyses will be performed on the whole cohort data and stratified by study site or country. ETHICS AND DISSEMINATION The study was approved by the Public Health authorities of each country where the study is being implemented. Findings from the COBA-Cohort study will be summarised in a report to the European Commission, and in leaflets to be distributed to study participants. Articles and conference abstracts will be submitted to peer-reviewed journals and conferences.
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Affiliation(s)
- Nicolas Lorente
- Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain
- The Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Laura Fernàndez-López
- Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain
- The Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Daniela Rojas Castro
- AIDES (MIRE-Mission Innovation Recherche Expérimentation), Pantin, France
- Groupe de Recherche en Psychologie Sociale (GRePS) EA4163, Université de Lyon 2, Bron, France
| | | | | | | | - Paula Meireles
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Raquel Lucas
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - Stéphane Morel
- AIDES (MIRE-Mission Innovation Recherche Expérimentation), Pantin, France
| | | | - Cristina Agustí
- Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain
- The Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Irena Klavs
- National Institute of Public Health, Ljubljana, Slovenia
| | - Tom Platteau
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Jordi Casabona
- Centre for Epidemiological Studies on HIV/STI of Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain
- The Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Univ Autonoma Barcelona, Badalona, Spain
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