HIV Point-of-Care Testing in Canadian Settings: A Scoping Review

Alexa Minichiello,Shabnam Asghari,Oliver Hurley,Meck Chongo,Sonia Gaudry,Aurélie Hot,Jacqueline Gahagan,Allison Maybank,Michelle Swab,Zack Marshall,Michael Schwandt

doi:10.3389/fpubh.2017.00076

Abstract

HIV point-of-care testing (POCT) was approved for use in Canada in 2005 and provides important public health benefits by providing rapid screening results rather than sending a blood sample to a laboratory and waiting on test results. Access to test results soon after testing (or during the same visit) is believed to increase the likelihood that individuals will receive their results and improve access to confirmatory testing and linkages to care. This paper reviews the literature on the utilization of HIV POCT across Canadian provinces. We searched OVID Medline, Embase, EBM Reviews, PsycINFO, CINAHL, and 20 electronic grey literature databases. All empirical studies investigating HIV POCT programs in Canada published in French or English were included. Searches of academic databases identified a total of 6,091 records. After removing duplicates and screening for eligibility, 27 records were included. Ten studies are peer-reviewed articles, and 17 are grey literature reports. HIV POCT in Canada is both feasible and accepted by Canadians. It is preferred to conventional HIV testing (ranging from 81.1 to 97%), and users are highly satisfied with the testing process (ranging between 96 and 100%). The majority of studies demonstrate that HIV POCT is feasible, preferred, and accepted by diverse populations in Canada. Losses to follow-up and linkage rates are also good. However, more research is needed to understand how best to scale up HIV POCT in contexts that currently have very limited or no access to testing.

Highlights

HIV testing and diagnosis is the first stage in the HIV continuum of care
Our scoping review investigated the utilization of HIV point-of-care testing (POCT) in Canada
The evidence in this review suggests that HIV POCT has broadened access to testing services for both those who have never tested and for return testers across much of Canada

Summary

Introduction

HIV testing and diagnosis is the first stage in the HIV continuum of care. Previous studies on HIV-infected individuals suggest that people who are aware of their HIV status are more likely to practice behaviors that lower the risk of HIV transmission, compared to people who are unaware of their HIV status (1). Public health practitioners recommend widespread availability and accessibility of HIV point-of-care testing (POCT) tests, for priority populations (2). A low-cost and easy-to-use test such as HIV POCT has great potential for advancing the UNAIDS 90–90–90 targets; the adoption, implementation, and performance of HIV POCT in practice has proved challenging (3). A systematic approach at the national level including the development of proper policies, regulations, and guidelines related to HIV POCT and a stepwise approach including attention to implementation have been recognized as key factors in improving HIV testing and diagnosis rates (4). HIV point-of-care testing (POCT) was approved for use in Canada in 2005 and provides important public health benefits by providing rapid screening results rather than sending a blood sample to a laboratory and waiting on test results. This paper reviews the literature on the utilization of HIV POCT across Canadian provinces

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Discussion

Conclusion