Abstract
Background
HIV continues to be an important public health issue. Voluntary community-based HIV testing (VCBT) helps to reduce the undiagnosed population of HIV-positive individuals, enabling early diagnosis and treatment. Monitoring is essential to determine whether at-risk groups are being effectively reached.
Aims
Our aim was to pilot and then introduce sustained monitoring of VCBT in Ireland, through collaboration between statutory and non-statutory organisations.
Methods
The study was initiated by the Health Protection Surveillance Centre in 2018. Steps included forming a multisectoral steering group and developing a minimum standardised dataset. De-identified case-based data were requested for VCBT carried out from 1 January 2017 onwards; this paper includes data for 2018.
Results
Six organisations participated; all four NGOs involved in VCBT, one medical charity, and the Health Service Executive National Social Inclusion Office. Methods were rapid point-of-care testing (POCT) (54%) or laboratory based (46%). Total HIV test reactivity was 1.7% (1.5% excluding persons later identified as previously diagnosed HIV positive). All POCT data were case based; the test reactivity rate was 0.8% and was higher in bar/club settings (1.2%). Most (74%) laboratory testing data were in aggregate format; the test positivity rate in one asylum centre was 5.0%. Ongoing challenges include testing among persons later identified as previously diagnosed HIV positive, monitoring case-based testing in asylum settings, and suboptimal data on confirmatory testing and linkage to care.
Conclusions
Sustained national monitoring in community settings will help inform HIV testing guidelines and will enable assessment of the impact of local and regional community HIV testing strategies.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
World Health Organisation HIV/AIDS Key Facts. https://www.who.int/news-room/fact-sheets/detail/hiv-aids. Accessed 12 August 2019
UNAIDS 2025 AIDS Targets. http://www.unaids.org/en/resources/909090. Accessed 12 August 2019
COBATEST NETWORK: Community-Based Voluntary Counselling and Testing in Europe. 2017 Report
European Centres for Disease Prevention and Control, Meeting Report. Monitoring HIV Testing in the EU/EAA. 19–20 October 2016: Stockholm
HSE Health Protection Surveillance Centre (2019) HIV estimates for 2018 in Ireland using Spectrum, a UNAIDS-supported modelling tool. Dublin: HSE HPSC
HSE Sexual Health and Crisis Pregnancy Programme (SHCPP) and HSE Health Protection Surveillance Centre (2018) Continuum of HIV Care, Ireland 2017. Dublin: HSE HPSC
European Centre for Disease Prevention and Control (2018) Public health guidance on HIV, hepatitis B and C testing in the EU/EEA–an integrated approach. Stockholm: ECDC
UK National Guidelines for HIV Testing (2008) British HIV Association and British Association of Sexual Health and HIV British Infection Society, 2008
BioLytical, INSTI™ HIV-1 Antibody Test, Summary of safety and effectiveness. https://www.fda.gov/downloads/BloodBloodProducts/UCM235253.pdf
HSE Health Protection Surveillance Centre (2019) Community HIV testing monitoring in Ireland, 2018. HSE HPSC, Dublin
Nash SG, Furegato M, Gill ON, Connor N and contributors. HIV testing in England: 2017 report. November 2017. Public Health England, London
Scognamiglio P, Chiaradia G, Giovanetti M et al. BMC Public Health (2018) 18:748 HIV rapid testing in community and outreach sites: results of a nationwide demonstration project in Italy
Fernandez-Lopez BR, Pujol F et al (2010) Impact of the introduction of rapid HIV testing in the voluntary counselling and testing sites network of Catalonia, Spain. Int J STD AIDS 21:388–391
De la Fuente L, Delgado J, Hoyos J et al. AIDS Patient Care and STDs Volume 23, Number 8, 2009. Increasing Early Diagnosis of HIV through Rapid Testing in a Street Outreach Program in Spain
Bowles K, Clark H, Tai E et al. Public Health Reports (Washington DC). 2008 Nov-Dec; 123 Suppl 3:78-85. Implementing rapid HIV testing in outreach and community settings: results from an advancing HIV prevention demonstration project conducted in seven U.S. cities
The COBATEST network: community–based voluntary counselling and testing in Europe. 2017 Report
Thornton AC, Delpech V, Kall MM, and A Nardone A. HIV testing in community settings in resource-rich countries: a systematic review of the evidence. HIV Medicine (2012), 13, 416–426
Gosselin A, Ravalihasy A, Pannetier J, Lert F and Desgrées du Loû A, for the PARCOURS Study Group Sexually Transmitted Infections Epub ahead of print: [accessed 05/03/2020]. doi:10.1136/ sextrans-2019-054080
Alvarez-del Arcoa D, Fakoyad I , Thomadakise C, Pantazise N, Touloumie G, Gennottef AF et al, on behalf of the Advancing Migrant Access to Health Services in Europe (aMASE) study team. AIDS 2017, Vol 31 No 14
HSE Health Protection Surveillance Centre (2019) HIV in Ireland, 2018. HSE HPSC, Dublin
National Sexual Health Strategy 2015–2020 and Action Plan 2015–2016, Department of Health in Ireland, 2015
Fast-Track Cities Global Web Portal. About Fast-Track Cities. http://www.fast-trackcities.org/about. Accessed 9 May 2019
Gov.ie - Get Involved. Healthy Ireland and Department of Health. https://www.gov.ie/en/publication/3e8ca2-get-involved/#healthy-cities-and-counties Accessed 16 May 2019
Dimbo I, Carson R (February 2019) Mind the gap report. AIDS Care Education & Training (ACET)
Drummond A, Codd M, Donnelly N, McCausland D, Mehegan J, Daly L, Kelleher C (2014) Study on the prevalence of drug use, including intravenous drug use, and blood-borne viruses among the Irish prisoner population. National Advisory Committee on Drugs and Alcohol, Dublin
Crowley D, Lambert J S, Betts-Symonds G, Cullen W, Keevans M, Kelly E, et al. (2017) The seroprevalence of untreated chronic hepatitis C virus (HCV) infection and associated risk factors in male Irish prisoners: a cross-sectional study. Euro Surveillance. 24(14)
HSE Health Protection Surveillance Centre (2019) Antenatal HIV screening in Ireland, 2018. HSE HPSC, Dublin
Acknowledgements
We would like to thank all those who contributed to this study including Erin Nugent and Niall Mulligan (HIV Ireland); Dr. Maureen Brennan (Medical Officer Balseskin); Dr. Evan Murphy (Principal Medical Officer Community Health CHO 9); Ifedinma Dimbo (ACET); Grainne Kelly and nurse practitioners at the GUIDE clinic in St. James’ Hospital, Dublin; Safetynet; GOSHH; SHC; AIDSWest; and all of the staff and volunteers of the KnowNow programme.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
The data included in this study were retrospective data and were fully anonymised; there were no patient/client identifiers received by the Health Protection Surveillance Centre for any participants included. For this type of study, formal consent is not required.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Brady, M., Shanley, A., Hurley, C. et al. Establishment of a national surveillance system to monitor community HIV testing, Ireland, 2018. Ir J Med Sci 189, 1507–1514 (2020). https://doi.org/10.1007/s11845-020-02217-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11845-020-02217-3