Reaching the First 90: Proposal for Intervention Strategy in Order to Expanding Access to HIV Testing among Migrant and Vulnerable Populations

Abstract

Background: UNAIDS proposed a set of three targets that, if achieved, are predicted to end the AIDS epidemic by 2030. The targets, known as 90-90- 90, call for 90% of people living with HIV (PLHIV) to know their status, 90% to receive antiretroviral therapy and 90% uptake of HIV tests. But insufficient data are reported on the estimated PLHIV prevalence on migrants and vulnerable populations across Europe. At the end to reduce this gap and to evaluate the behavioural characteristics of these populations, the HIV rapid test and counselling were offered inside a public health project. Methods and findings: During the period December 2012-2013 all migrants and Italian people, aged between 16-70 years old, attending the infectious disease clinic of the National Institute for Health, Migration and Poverty (INMP) in Rome, Italy, were enrolled. HIV rapid testing was free and patients were asked to fill in a questionnaire evaluating knowledge about HIV/STIs, prevention methods, sexual behaviours and stigma. Patients with sexual risk behaviours or with a recent diagnosis of STIs were invited to come back after 3-6 months and a postcounselling questionnaire was offered. Out of the total sample, 99.2% accepted the “rapid test”; 13 participants resulted positive (1.45%; 95% CI: 0.75-2.53) with 10 new diagnosis (1.22%; 95% CI 0.58%-2.22%). 46% answered the questionnaire and 18.6% completed the follow-up. Conclusion: The approach providing HIV rapid test, associated to other instruments, such peer mediators inside the counselling setting, could be useful for the health care services and prevention programs to expanding access for vulnerable populations. But this approach reiterates the need of new policies toward marginalized populations at the aim to encouraging the access to health services and to refer to preventions programs.