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Canadian Journal of Public Health

, Volume 105, Issue 1, pp e53–e62 | Cite as

A systematic review of HIV testing among Canadian populations

  • Shalane HaEmail author
  • Dana Paquette
  • Jill Tarasuk
  • Jeff Dodds
  • Margaret Gale-Rowe
  • James I. Brooks
  • John Kim
  • Tom Wong
Systematic Review
  • 3 Downloads

Abstract

OBJECTIVE: Regular HIV testing and early detection leads to timely treatment. Appropriate treatment and care can prevent disease progression in the individual and prevent onwards transmission within the community. This review describes HIV testing coverage in populations disproportionately affected by HIV and in the general population in Canada.

METHODS: A search of published and grey literature on HIV testing uptake in Canada was conducted. Studies reporting quantitative data on testing practices (ever tested, recent testing, and regular testing), published in either English or French from 2008–2012, were included. Studies that involved testing for immigration or prenatal purposes, and post-intervention studies, were excluded. Included studies were assessed using a modified version of the Public Health Agency of Canada’s Descriptive Study Critical Appraisal Tool. Pooled prevalence for percent ever tested was calculated for subpopulations and heterogeneity was estimated using the l2 statistic.

SYNTHESIS: A total of 26 studies were included in the review. The highest rates of ever having been tested were among people who inject drugs (90.6%) and inmates (90.4%); followed by men who have sex with men (83.0%); Aboriginal peoples (55.5%); and the general population (32.8%). Limited information was available on regular and recent testing.

CONCLUSION: HIV testing can reduce the number of undiagnosed cases in Canada. Future research should focus on testing coverage in certain populations, and on the extent to which populations engage in regular testing.

Key words

HIV Canada testing prevention 

Résumé

OBJECTIF: Des tests réguliers de dépistage et une détection précoce du VIH entraînent un traitement en temps opportun. Des traitements et des soins appropriés peuvent éviter la progression de la maladie chez un individu et prévenir la retransmission du virus au sein d’une collectivité. Le présent examen décrit la couverture de dépistage du VIH au sein des populations disproportionnellement touchées par le VIH et au sein de la population générale du Canada.

MÉTHODES: Une recherche a été menée à l’échelle de la littérature grise et des documents publiés sur la prise de tests de dépistage du VIH au Canada. Des études signalant des données quantitatives sur des pratiques de dépistage (sujets ayant déjà passé un test, sujets testés récemment et sujets procédant à des tests réguliers), publiées en anglais ou en français de 2008 à 2012, ont été incluses dans la recherche. Les études portant sur le dépistage prénatal ou auprès des immigrants et les études menées après les interventions, elles, ont été exclues. Les études incluses ont été évaluées à l’aide d’une version modifiée de l’outil d’évaluation critique pour les études descriptives de l’Agence de la santé publique du Canada. La prévalence groupée pour le pourcentage de gens ayant déjà passé un test de dépistage a été calculée pour les sous-populations, et l’hétérogénéité a été estimée à l’aide de la statistique l2.

SYNTHÈSE: Au total, 26 études ont été incluses dans l’examen. Les utilisateurs de drogues injectables (90,6 %) et les détenus (90,4 %) avaient les taux les plus élevés de tests de dépistage. Ces groupes étaient suivis des hommes ayant des relations sexuelles avec d’autres hommes (83 %), des Autochtones (55,5 %) et de la population générale (32,8 %). Les renseignements accessibles sur les tests réguliers et les tests récents étaient limités.

CONCLUSION: Les tests de dépistage du VIH peuvent réduire le nombre de cas non diagnostiqués au Canada. Les prochaines recherches devraient insister sur la couverture du dépistage au sein de certaines populations et sur la mesure dans laquelle les populations procèdent à des tests réguliers.

Mots clés

VIH Canada dépistage prévention 

References

  1. 1.
    Public Health Agency of Canada. Summary: Estimates of HIV Prevalence and Incidence in Canada, 2011. Ottawa, ON: Public Health Agency of Canada, 2012. Available at: http://www.phac-aspc.gc.ca/aids-sida/publication/survreport/estimat2011-eng.php (Accessed April 4, 2013).Google Scholar
  2. 2.
    Thompson MA, Aberg JA, Cahn P, Montaner JS, Rizzardini G, Telenti A, et al. Antiretroviral treatment of adult HIV infection: 2010 recommendations of the International AIDS Society-USA panel. JAMA 2010;304(3):321–33.CrossRefGoogle Scholar
  3. 3.
    Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: Implications for HIV prevention programs. J Acquit Immun Defic Syndr 2005;39(4):446–53.CrossRefGoogle Scholar
  4. 4.
    Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med 2011;365(6):493–505.CrossRefGoogle Scholar
  5. 5.
    World Health Organization. Guidance on provider-initiated HIV testing and counselling in health facilities. Geneva, Switzerland: WHO, 2013. Available at: http://www.who.int/hiv/pub/guidelines/9789241501972/en/index.html (Accessed June 17, 2013).Google Scholar
  6. 6.
    Public Health Agency of Canada. Human immunodeficiency virus HIV screening and testing guide. Ottawa: PHAC, 2013. Available at: http://www.phac-aspc.gc.ca/aids-sida/guide/hivstg-vihgdd-eng.php (Accessed June 17, 2013).Google Scholar
  7. 7.
    Saskatchewan HIV Provincial Leadership Team. Saskatchewan HIV testing policy. Saskatchewan HIV Provincial Leadership Team, 2012. Available at: http://www.skhiv.ca/SK%20HIV%20Testing%20Policy%20Final%20Dec%202012%20(2).pdf (Accessed June 6, 2013).Google Scholar
  8. 8.
    BC Centre for Disease Control. Communicable Disease Control Manual–Chapter 5: Point of care HIV testing guidelines for health care settings. Vancouver, BC: BC Centre for Disease Control, 2012. Available at: http://www.bccdc.ca/NR/rdonlyres/8D50320D-9175-4FCD-81AB-623E9C051277/0/PointofCareHIVTestGuidelinesforHealthCareSettings-May2012.pdf (Accessed June 6, 2013).Google Scholar
  9. 9.
    European Centre for Disease Prevention and Control. HIV testing: Increasing uptake and effectiveness in the European Union. Stockholm, Sweden: ECDC, 2010. Available at: http://www.ecdc.europa.eu/en/publications/publications/101129_gui_hiv_testing.pdf (Accessed June 6, 2013).Google Scholar
  10. 10.
    Moyer VA. Screening for HIV: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med 2013;159(1):51–60.CrossRefGoogle Scholar
  11. 11.
    Branson BM, Handsfield HH, Lampe MA, Janssen RS, Taylor AW, Lyss SB, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR 2006;55(RR14):1–17.PubMedGoogle Scholar
  12. 12.
    Public Health Agency of Canada. Infection prevention and control guidelines: Critical appraisal tool kit. Ottawa: PHAC, In Press 2013.Google Scholar
  13. 13.
    Husbands W, Makoroka L, George C, Adam B, Remis R, Rourke S, et al. Mabwana health, community and vulnerability to HIV among African, Caribbean and black gay and bisexual men in Toronto. The African and Caribbean Council on HIV/AIDS in Ontario (ACCHO) and the AIDS Committee of Toronto, 2008. Available at: http://www.actoronto.org/research.nsf/pages/mabwanareport/$file/MaBwana%20Black%20Men’s%20Study%20of%20vulnerability%20to%20HIV%20among%20Black%20Gay%20and%20Bisexual%20Men%20in%20Toronto%202009.pdf (Accessed April 4, 2013).Google Scholar
  14. 14.
    Lambert G, Cox J, Miangotar Y, Tremblay C, Alary M, Otis J, et al. ARGUS cycle 2008–2009. Montreal, QC: Institut national de santé publique, 2011.Google Scholar
  15. 15.
    Moore DM, Kanters S, Michelow W, Gustafson R, Hogg RS, Kwag M, et al. Implications for HIV prevention programs from a serobehavioural survey of men who have sex with men in Vancouver, British Columbia: The Mancount Study. Can J Public Health 2012;103(2):142–46.PubMedGoogle Scholar
  16. 16.
    Public Health Agency of Canada. M-track: Enhanced surveillance of HIV, sexually transmitted and blood-borne infections, and associated risk behaviours among men who have sex with men in Canada, Phase 1 report. Ottawa: PHAC, 2011. Available at: http://www.orders.catie.ca/product_info.php?cPath=14_53&products_id=25916 (Accessed April 4, 2013).Google Scholar
  17. 17.
    Poon MKL, Wong JPH, Sutdhibhasilp N, Ho PTT, Wong B. HIV and STI testing among East and Southeast Asian men who have sex with men in Toronto. Can J Hum Sex 2011;20(4):157–66.Google Scholar
  18. 18.
    Community Based Research Centre. Sex now 2010 survey report. Community-Based Research Centre, 2011. Available at: http://www.cbrc.net/resources/2011/sex-now-2010-survey-report (Accessed April 2, 2013).Google Scholar
  19. 19.
    White SJ, Hopkins S, Shahin R, Millson PM. Comparison of HIV testing behaviours in injection drug users and non-injecting users of crack-cocaine. Can J Infect Dis Med 2012;23(Suppl A):85A.Google Scholar
  20. 20.
    Bennett R, Tarasuk J, George DB, Ogunnaike-Cooke S, Archibald CP, I-Track Site Principal Investigators. Access, use and availability of services: Results from a national enhanced HIV surveillance system among people who inject drugs. Can J Infect Dis Med 2012;23(Suppl A):107A–108A.Google Scholar
  21. 21.
    Leclerc P, Roy É, Morissette C, Alary M, Parent R, Blouin K. Surveillance des infections transmissibles sexuellement et par le sang: surveillances des maladies infectieuses chez les utilisateurs de drogue par injection. Gouvernement de Québec, 2012.Google Scholar
  22. 22.
    Mill JE, Jackson RC, Worthington CA, Archibald C, Wong T, Myers T, et al. HIV testing and care in Canadian Aboriginal youth: A community-based mixed methods study. BMC Infect Dis 2008;8(132):1–13.Google Scholar
  23. 23.
    Moniruzzaman A, Christian WM, Patel S, Pearce ME, Schechter MT, Spittal PM. The Cedar Project: Correlates of accessing HIV testing among young Aboriginal people who use non-injection and injection drugs in Vancouver and Prince George, BC. Can J Infect Dis Med 2010;21(Suppl B):21B.Google Scholar
  24. 24.
    Orchard TR, Druyts E, McInnes CW, Clement K, Ding E, Fernandes KA, et al. Factors behind HIV testing practices among Canadian Aboriginal peoples living off-reserve. AIDS Care 2010;22(3):324–31.CrossRefGoogle Scholar
  25. 25.
    Bonnycastle KD, Villebrun C. Injecting risk into prison sentences: A quantitative analysis of a prisoner-driven survey to measure HCV/HIV seroprevalence, risk practices, and viral testing at one Canadian male federal prison. Prison J 2011;91(3):325–46.CrossRefGoogle Scholar
  26. 26.
    Zakaria D, Thompson JM, Jarvis A, Smith J. Testing and treatment for human immunodeficiency virus and hepatitis C virus infections among Canadian federal inmates. Correctional Service of Canada, 2010. Available at: http://www.csc-scc.gc.ca/text/rsrch/smmrs/rg/rg-r223/rg-r223-eng.shtml (Accessed April 4, 2013).Google Scholar
  27. 27.
    EKOS Research Associates Inc. 2012 HIV/AIDS attitudinal tracking survey. EKOS Research Associates Inc., 2012. Available at: http://www.ekos.com/admin/articles/038-12.pdf (Accessed April 2, 2013).Google Scholar
  28. 28.
    Calzavara L, Allman D, Worthington C, Tyndall M, Adrien A. HIV and AIDS in Canada: A national survey summary report. The CIHR Social Research Centre in HIV Prevention, 2012. Available at: http://www.srchiv.ca/NationalSurvey/wp-content/uploads/2012/04/Attitudinal-Survey-Summary-ReportJunel5.pdf (Accessed April 2, 2013).Google Scholar
  29. 29.
    Bauer GR, Travers R, Scanlon K, Coleman TA. High heterogeneity of HIV related sexual risk among transgender people in Ontario, Canada: A province-wide respondent-driven sampling survey. BMC Public Health 2012;12(292):1–12.Google Scholar
  30. 30.
    Raffa JD, Grebely J, Lai C, Krajden M, Kerr T, Tyndall MW. Uptake of HIV testing in a large community-based study of inner city residents. Can J Infect Dis Med 2009;20(Suppl B):30B.Google Scholar
  31. 31.
    Deering KN, Montaner JS, Feng CX, Chettiar J, Strathdee SA, Shannon K. Successes and gaps in regular HIV testing for hidden street- and off-street sex workers in Vancouver, Canada. Can J Infect Dis Med 2012;23(Suppl A):33A.Google Scholar
  32. 32.
    Gray K, Calzavara L, Tharao W, Johns A. The East African Health Study in Toronto (EAST): Results from a survey of HIV and health-related behaviour, beliefs, attitudes, and knowledge. Toronto, ON: University of Toronto, 2008. Available at: http://www.accho.ca/pdf/EAST%20report-Final14Nov08.pdf (Accessed April 2, 2013).Google Scholar
  33. 33.
    Vibert M. The safe and sexy project: The sexual-health needs and knowledge of homeless and street-involved youth living in Hamilton, Ontario [thesis]. Waterloo, ON: University of Waterloo, 2010.Google Scholar
  34. 34.
    Schwandt M, Nicolle E, Dunn S. Preferences for rapid point-of-care HIV testing in primary care. JIAPAC 2012;11(3):157–63.PubMedGoogle Scholar
  35. 35.
    Wagner AC, Hart TA, Ghai A, Roberts K. The role of social anxiety and fear of being judged negatively on HIV testing status in young adults. Can J Infect Dis Med 2008;19(Supplement SA):P231.Google Scholar
  36. 36.
    Peterman A. Physician initiated STI prevention counselling: Targeting women to reach couples [thesis]. London, ON: niversity of Western Ontario, 2008.Google Scholar
  37. 37.
    Mairs K. The lifestyles and sexual health of Canadian snowbirds [thesis]. Waterloo: University of Waterloo, 2009.Google Scholar
  38. 38.
    Ghai A. HIV risk and HIV testing behaviours among South Asian Canadian young adults: The role of social context and individual level variables [thesis]. Toronto: York University, July 2008.Google Scholar
  39. 39.
    Flowers P, Knussen C, Li J, McDaid L. Has testing been normalized? An analysis of changes in barriers to HIV testing among men who have sex with men between 2000 and 2010 in Scotland, UK. HIV Med 2013;14(2):92–98.CrossRefGoogle Scholar
  40. 40.
    Finlayson TJ, Le B, Smith A, Bowles K, Cribbin M, Miles A, et al. HIV risk, prevention, and testing behaviors among men who have sex with men -National HIV Behavioral Surveillance System, 21 U.S. cities, United States, 2008. MMWR 2011;60(SS14):1–34.PubMedGoogle Scholar
  41. 41.
    Guy R, Goller JL, Spelman T, El-Hayek C, Gold J, Lim M, et al. Does the frequency of HIV and STI testing among men who have sex with men in primary care adhere with Australian guidelines? Sex Transm Infect 2010;86(5):371–76.CrossRefGoogle Scholar
  42. 42.
    Alvarez-del Arco D, Monge S, Azcoaga A, Rio I, Hernando V, Gonzalez C, et al. HIV testing and counselling for migrant populations living in high-income countries: A systematic review. Eur J Public Health Epub 2012;1–7.Google Scholar
  43. 43.
    Iversen J, Maher L. Australian NSP survey national data report 2007–2011. The Kirby Institute, University of New South Wales, 2012. Available at: http://www.kirby.unsw.edu.au/sites/default/files/hiv/resources/ANSPS_2007-2011.pdf (Accessed May 16, 2013).Google Scholar
  44. 44.
    Centers for Disease Control and Prevention (CDC). HIV infection and HIV associated behaviors among injection drug users–20 cities, United States, 2009. MMWR 2012;61(8):133–38.Google Scholar
  45. 45.
    Statistics Canada. 2011 National Household Survey: Aboriginal peoples in Canada: First Nations people, Métis, and Inuit. Ottawa: Statistics Canada, 2013. Available at: http://www.statcan.gc.ca/daily-quotidien/130508/dql30508a-eng.htm (Accessed May 16, 2013).Google Scholar
  46. 46.
    Duncan KC, Reading C, Borwein AM, Murray MCM, Palmer A, Michelow W, et al. HIV incidence and prevalence among Aboriginal peoples in Canada. AIDS Behav 2011;15(1):214–27.CrossRefGoogle Scholar
  47. 47.
    Public Health Agency of Canada. Population-specific HIV/AIDS status report: Aboriginal peoples. Ottawa: PHAC, 2010. Available at: http://www.phac-aspc.gc.ca/aids-sida/publication/ps-pd/aboriginal-autochtones/index-eng.php (Accessed May 16, 2013).Google Scholar
  48. 48.
    Houston S, Archibald CP, Strike C, Sutherland D. Factors associated with HIV testing among Canadians: Results of a population-based survey. Int J STD AIDS 1998;9(6):341–46.CrossRefGoogle Scholar
  49. 49.
    Kaai S, Bullock S, Burchell AN, Major C. Factors that affect HIV testing and counseling services among heterosexuals in Canada and the United Kingdom: An integrated review. Patient Educ Couns 2012;88(1):4–15.CrossRefGoogle Scholar
  50. 50.
    Worthington C, O’Brien K, Myers T, Nixon S, Cockerill R. Expanding the lens of HIV services provision in Canada: Results of a national survey of HIV health professionals. AIDS Care 2009;21(11):1371–80.CrossRefGoogle Scholar
  51. 51.
    Sutton M, Anthony M, Vila C, McLellan-Lemal E, Weidle PJ. HIV testing and HIV/AIDS treatment services in rural counties in 10 southern states: Service provider perspectives. J Rural Health 2010;26(3):240–47.CrossRefGoogle Scholar
  52. 52.
    Miller CL, Pearce ME, Moniruzzaman A, Thomas V, Christian W, Schechter MT, et al. The Cedar Project: Risk factors for transition to injection drug use amongyoung, urban Aboriginal people. CMAJ 2011;183(10):1147–54.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 2014

Authors and Affiliations

  • Shalane Ha
    • 1
    Email author
  • Dana Paquette
    • 1
  • Jill Tarasuk
    • 1
  • Jeff Dodds
    • 1
  • Margaret Gale-Rowe
    • 1
  • James I. Brooks
    • 1
  • John Kim
    • 1
  • Tom Wong
    • 1
  1. 1.Centre for Communicable Diseases and Infection Control (CCDIC), Public Health Agency of CanadaOttawaCanada

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