Assessment of an outreach street-based HIV rapid testing programme as a strategy to promote early diagnosis: a comparison with two surveillance systems in Spain, 2008-2011

• Published in: Euro surveillance : bulletin européen sur les maladies transmissibles Vol. 20; no. 14; p. 1
• Main Authors: Belza, M J, Hoyos, J, Fernández-Balbuena, S, Diaz, A, Bravo, M J, de la Fuente, L
• Format: Journal Article
• Language: English
• Published: Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 09-04-2015
• Subjects: Adult; Community service; Disease prevention; Early Diagnosis; Female; HIV; HIV Infections - diagnosis; HIV Infections - epidemiology; HIV Infections - prevention & control; Homosexuality, Male - statistics & numerical data; Human immunodeficiency virus; Humans; Male; Mass Screening - methods; Medical diagnosis; Medical tests; Mens health; Mobile Health Units; Population Surveillance - methods; Prevalence; Program Evaluation; Risk-Taking; Sexual behavior; Sexual Behavior - statistics & numerical data; Spain - epidemiology; Spain
• ISSN: 1560-7917; 1025-496X; 1560-7917
• DOI: 10.2807/1560-7917.ES2015.20.14.21089

We assess the added value of a multisite, street-based HIV rapid testing programme by comparing its results to pre-existing services and assessing its potential to reduce ongoing transmission. Between 2008 and 2011, 8,923 individuals underwent testing. We compare outcomes with those of a network of 20 sexually transmitted infections (STI)/HIV clinics (EPI-VIH) and the Spanish National HIV Surveillance System (SNHSS); evaluate whether good visibility prompts testing and assess whether it reaches under-tested populations. 89.2% of the new infections were in men who have sex with men (MSM) vs 78.0% in EPI-VIH and 56.0% in SNHSS. 83.6% of the MSM were linked to care and 20.9% had <350 CD4 HIV prevalence was substantially lower than in EPI-VIH. 56.5% of the HIV-positive MSM tested because they happened to see the programme, 18.4% were previously untested and 26.3% had their last test ≥2 years ago. The programme provided linkage to care and early diagnosis mainly to MSM but attendees presented a lower HIV prevalence than EPI-VIH. From a cost perspective it would benefit from being implemented in locations highly frequented by MSM. Conversely, its good visibility led to reduced periods of undiagnosed infection in a high proportion of MSM who were not testing with the recommended frequency.