alexa HIV testing in community settings in resource-rich countries: a systematic review of the evidence.
Infectious Diseases

Infectious Diseases

Journal of AIDS & Clinical Research

Author(s): Thornton AC, Delpech V, Kall MM, Nardone A

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Abstract OBJECTIVES: Community HIV testing represents an opportunity for diagnosing HIV infection among individuals who may not have contact with health services, especially in hard-to-reach groups. The aim of this review was to assess the evidence for feasibility, acceptability and effectiveness of HIV testing strategies in community settings in resource-rich countries. METHODS: The PubMed database was searched for English language studies of outreach HIV testing in resource-rich countries. Studies were included if they reported one of the following outcome measures: uptake of testing; seropositivity; client acceptability; or provider acceptability. RESULTS: Forty-four studies were identified; the majority took place in the USA and targeted men who have sex with men. Uptake of HIV testing varied between 9 and 95\% (in 14 studies). Seropositivity was ≥ 1\% in 30 of 34 studies. In 16 studies the proportion of patients who received their test results varied from 29 to 100\% and rapid testing resulted in a higher proportion of clients receiving their results. Overall, client satisfaction with community HIV testing was high. However, concern remained over confidentiality, professional standards and the need for post-test counselling. Staff reported positive attitudes towards community testing. CONCLUSIONS: In the majority of studies, the reported seropositivity was higher than 1/1000, the threshold deemed to be cost-effective for routinely offering testing. Rapid testing improved the return of HIV test results to clients. HIV testing in outreach settings may be important in identifying undiagnosed infections in at-risk populations, but appropriate data to evaluate these initiatives must be collected. © 2012 British HIV Association. This article was published in HIV Med and referenced in Journal of AIDS & Clinical Research

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