LOGIN TO YOUR ACCOUNT

Username
Password
Remember Me
Or use your Academic/Social account:

CREATE AN ACCOUNT

Or use your Academic/Social account:

Congratulations!

You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.

Important!

Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message

CREATE AN ACCOUNT

Name:
Username:
Password:
Verify Password:
E-mail:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Jelliman Pauline; Harrison Ian; Spaine Vida; Coffey Emer; Jones Kathy; Chawla Anu; MacPherson Peter; Phillips-Howard Penelope; Beynon Caryl; Taegtmeyer Miriam (2011)
Publisher: BioMed Central
Journal: BMC Public Health
Languages: English
Types: Article
Subjects: Research Article, RA1-1270, Public aspects of medicine, qy_4, wa_110, wc_503_6

Abstract

Background

In Liverpool, injecting drug users (IDUs), men-who-have-sex-with-men (MSM) and UK Africans experience a disproportionate burden of HIV, yet services do not reach out to these groups and late presentations continue. We set out to: increase testing uptake in targeted marginalized groups through a community and genitourinary medicine (GUM)-based point of care testing (POCT) programme; and conduct a process evaluation to examine service provider inputs and document service user perceptions of the programme.

Methods

Mixed quantitative, qualitative and process evaluation methods were used. Service providers were trained to use fourth generation rapid antibody/antigen HIV tests. Existing outreach services incorporated POCT into routine practice. Clients completed a semi-structured questionnaire and focus group discussions (FGDs) were held with service providers.

Results

Between September 2009 and June 2010, 953 individuals underwent POCT (GUM: 556 [59%]; community-based sites: 397 [42%]). Participants in the community were more likely to be male (p = 0.028), older (p < 0.001), of UK African origin (p < 0.001) and IDUs (p < 0.001) than participants from the GUM clinic. Seventeen new HIV diagnoses were confirmed (prevalence = 1.8%), 16 of whom were in risk exposure categories (prevalence: 16/517, 3.1%). Questionnaires and FGDs showed that clients and service providers were supportive of POCT, highlighting benefits of reaching out to marginalised communities and incorporating HIV prevention messages.

Conclusions

Community and GUM clinic-based POCT for HIV was feasible and acceptable to clients and service providers in a low prevalence setting. It successfully reached target groups, many of whom would not have otherwise tested. We recommend POCT be considered among strategies to increase the uptake of HIV testing among groups who are currently underserved.

  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. British HIV Association HIV: British Association for Sexual Health & HIV and British Infection Society. UK National Guidelines for HIV Testing 2008.
    • 2. Poljak M, Smit E, Ross J: 2008 European Guideline on HIV testing. Int J STD AIDS 2009, 20:77-83.
    • 3. Branson BM, Handsfield HH, Lampe MA, Janssen RS, Taylor AW, Lyss SB, Clark JE, Centers for Disease Control and Prevention (CDC): Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep 2006, 55:1-17, quiz CE1-4.
    • 4. Health Protection Agency UK: HIV in the United Kingdom: 2009 Report. 2009.
    • 5. Burns FM, Fakoya AO, Copas AJ, French PD: Africans in London continue to present with advanced HIV disease in the era of highly active antiretroviral therapy. AIDS 2001, 15:2453-5.
    • 6. Burns FM, Johnson AM, Nazroo J, Ainsworth J, Anderson J, Fakoya A, Fakoya I, Hughes A, Jungmann E, Sadiq ST, Sullivan AK, Fenton KA: SONHIA Collaboration Group. Missed opportunities for earlier HIV diagnosis within primary and secondary healthcare settings in the UK. AIDS 2008, 22:115-22.
    • 7. Health Protection Agency: Shooting Up: Infections among injecting drug users in the United Kingdom 2007. 2008, An update October 2008.
    • 8. Marum E, Taegtmeyer M, Chebet K: Scale-up of voluntary HIV counseling and testing in Kenya. JAMA 2006, 296:859-62.
    • 9. Piot P, Bartos M, Larson H, Zewdie D, Mane P: Coming to terms with complexity: a call to action for HIV prevention. Lancet 2008, 372:845-59.
    • 10. Chadborn , Delpech , Sabin , Sinka , Evans : The late diagnosis and consequent short-term mortality of HIV-infected hetrosexuals (England and Wales 2000-2004). AIDS 2006, 20:2371-9.
    • 11. Lucas , Curtis , Johnson : National review of death among HIV-infected adults. Clin Med 2008, 8:250.
    • 12. Udayaraj , Tang , Vaux , Barker , Naik : HIV-related admissions to a district general hospital in the UK: a single centre study. Clin Med 2009, 9:333-7.
    • 13. Surah S, O'Shea S, Dunn H, Mitra R, Fitzgerald C, Ibrahim F, Sethi G: Utilization of HIV point-of-care testing clinics in general practice and genitourinary medicine services in south-east London. Int J STD AIDS 2009, 20:168-9.
    • 14. Calderon Y, Leider J, Hailpern S, Chin R, Ghosh R, Fettig J, Gennis P, Bijur P, Bauman L: High-volume rapid HIV testing in an urban emergency department. AIDS Patient Care STDS 2009, 23:749-55.
    • 15. Forsyth SF, Agogo EA, Lau L, Jungmann E, Man S, Edwards SG, Robinson AJ: Would offering rapid point-of-care testing or non-invasive methods improve uptake of HIV testing among high-risk genitourinary medicine clinic attendees? A patient perspective. Int J STD AIDS 2008, 19:550-2.
    • 16. Kendrick SR, Kroc KA, Withum D, Rydman RJ, Branson BM, Weinstein RA: Outcomes of offering rapid point-of-care HIV testing in a sexually transmitted disease clinic. J Acquir Immune Defic Syndr 2005, 38:142-6.
    • 17. Stokes SH, McMaster P, Ismail KM: Acceptability of perinatal rapid pointof-care HIV testing in an area of low HIV prevalence in the UK. Arch Dis Child 2007, 92:505-8.
    • 18. White DA, Scribner AN, Huang JV: A comparison of patient acceptance of fingerstick whole blood and oral fluid rapid HIV screening in an emergency department. J Acquir Immune Defic Syndr 2009, 52:75-8.
    • 19. Prost A, Griffiths C, Anderson J, Wight D, Hart G: Feasibility and acceptability of offering rapid HIV tests to patients registering with primary care in London (UK): a pilot study. Sex Transm Infect 2009, 85(5):326-9.
    • 20. Bailey AC, Roberts J, Weatherburn P, Hickson FC, Reid DS, Fisher M, Dean G: Community HIV testing for men who have sex with men: results of a pilot project and comparison of service users with those testing in genitourinary medicine clinics. Sex Transm Infect 2009, 85:145-7.
    • 21. Bryce G: HIV testing in primary care. BMJ 2009, 338:b1085.
    • 22. Clark HA, Bowles KE, Song B, Heffelfinger JD: Implementation of rapid HIV testing programs in community and outreach settings: perspectives from staff at eight community-based organizations in seven U.S. cities. Public Health Rep 2008, 123(Suppl 3):86-93.
    • 23. Knapp H, Anaya HD, Feld JE: Expanding HIV rapid testing via point-ofcare paraprofessionals. Int J STD AIDS 2008, 19:629-32.
    • 24. Macgowan R, Margolis A, Richardson-Moore A, Wang T, Lalota M, French PT, Stodola J, McKeever J, Carrel J, Mullins J, Llanas M, Griffiths SD, Rapid Testing in Corrections (RTIC) Team: Voluntary rapid human immunodeficiency virus (HIV) testing in jails. Sex Transm Dis 2009, 36: S9-13.
    • 25. Schulden JD, Song B, Barros A, Mares-DelGrasso A, Martin CW, Ramirez R, Smith LC, Wheeler DP, Oster AM, Sullivan PS, Heffelfinger JD: Rapid HIV testing in transgender communities by community-based organizations in three cities. Public Health Rep 2008, 123(Suppl 3):101-14.
    • 26. Inverness Medical Innovations Inc: Determine HIV-1/2 Ag/Ab Combo. Performance Data. 2010.
    • 27. Prost A, Sseruma WS, Fakoya I, Arthur G, Taegtmeyer M, Njeri A, Fakoya A, Imrie J: HIV voluntary counselling and testing for African communities in London: learning from experiences in Kenya. Sex Transm Infect 2007, 83:547-51.
  • No related research data.
  • No similar publications.

Share - Bookmark

Funded by projects

  • WT

Cite this article