The contribution of HIV point-of-care tests in early HIV diagnosis: community-based HIV testing monitoring in Catalonia, 1995 to 2018

Abstract

BackgroundCommunity-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.AimTo 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.MethodsA 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.ResultsBetween 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%.ConclusionOur study reinforces the important role that community-based HIV POCT has on the diagnosis of HIV in key populations.

Keywords: Community Health Services; HIV infections, diagnosis, prevention and control; early diagnosis; sentinel surveillance; statistics and numerical data; testing.

Figure 1

Number of HIV tests performed^a and percentage of reactive tests by year, Catalonia, Spain, 1995–2018 (n = 129,117)

Figure 2

Gender, age, origin and transmission group of (A) all people tested for HIV (n = 112,732^a) and (B) HIV reactive tests (n = 2,848), Catalonia, Spain, 1995–2018

Figure 3

Distribution by transmission group of (A) all people HIV tested^a (n=106,992) and (B) HIV reactive tests (n=2,786), Catalonia, Spain, 1995–2018

Figure 4

Percentage of HIV reactive tests by transmission group per year, Catalonia, Spain, 1995–2018 (n people tested = 106,992^a; n reactive tests = 2,848^b)

Figure 5

Number of HIV reactive screening tests from the DEVO network, total number of cases registered in the Catalonia HIV registry and the percentage^a of tests recorded in the Catalonia HIV registry first detected in the DEVO network for (A) all people tested (n = 2,483 in DEVO network, n = 13,004 in HIV registry) and (B) men who have sex with men and male sex workers only (n = 2,099 in DEVO network, n = 5,660 in HIV registry), Catalonia, Spain, 2001–2017