Ability of a rapid HIV testing site to attract and test vulnerable populations: a cross-sectional study on Actuel sur Rue

Abstract

Quebec’s HIV epidemic persists, particularly among men who have sex with men (MSM) and in Montreal. Increasing access to HIV testing is necessary and community-based rapid testing offers one strategy. This paper examines the clienteles and activities of a rapid HIV testing site in Montreal, the pilot project Actuel sur Rue. Comparative analyses were conducted with 1357 MSM, 147 heterosexual men and 64 women who visited Actuel sur Rue between July 2012 and November 2013 on socio-demographics, health, drug use, sexual practices/infection and HIV testing/prevention. Significant group differences were observed in each category. Actuel sur Rue received 1901 clients, conducted 1417 rapid HIV tests and tested 77 never-tested individuals. Rapid testing produced a high reactive rate (2%). Only 1/28 of those with reactive tests had no previous HIV testing, and 36% had used post-exposure prophylaxis, suggesting missed opportunities for prevention. Findings highlight diverse client vulnerability profiles and the relevance of checkpoints and further prevention efforts.

Keywords

HIV AIDS screening rapid test prevention checkpoint Canada MSM heterosexual men women

Get full access to this article

View all access options for this article.

References

Public Health Agency of Canada (PHAC). HIV and AIDS in Canada: surveillance report to December 31st, 2013, Ontario: PHAC, 2014.

Institut National de la Santé Publique du Québec (INSPQ). Programme de surveillance de l’infection par le virus de l’immunodéficience humaine (VIH) au Québec: rapport annuel 2013, Quebec: INSPQ, 2014.

INSPQ. Optimiser le dépistage et le diagnostic de l’infection par le virus de l’immunodéficience humaine, Québec: INSPQ, 2011.

Tooley

. A rapid approach to community-based HIV testing. Prevention in Focus, Ontario: Canadian AIDS Treatment Information Exchange, 2010.

PHAC. Summary: estimates of HIV prevalence and incidence in Canada, 2011, Ontario: PHAC, 2012.

Lambert

Cox

Miangotar

. ARGUS 2008–2009: a survey on HIV, viral hepatitis and sexually transmitted infections (STI) as well as associated risk behaviours among Quebec men who have sex with men (MSM), Canada: Direction de Santé Publique de l'Agence de la Santé et des Services Sociaux de Montréal, INSPQ and the PHAC, 2011.

LeBreton

. The erasure of sex and gender minorities in the healthcare system. BioethiqueOnline 2013; 2: 17–17.

Pottie

Batista

Mayhew

. Improving delivery of primary care for vulnerable migrants. Can Fam Physician 2014; 60: e32–40.

Tjepkema

. Health care use among gay, lesbian and bisexual Canadians. Health Rep 2008; 19: 52–64.

10.

Brenner

Roger

Stephens

. Transmission clustering drives the onward spread of the HIV epidemic among men who have sex with men in Quebec. J Infect Dis 2011; 204: 1115–1119.

11.

Geretti

Tsakiroglou

. HIV: new drugs, new guidelines. Curr Opin Infect Dis 2014; 27: 545–553.

12.

Rousseau R, Otis J, Blais M, et al. Implantation d’une intervention de dépistage rapide du VIH en milieu communautaire: motivation à se faire dépister et satisfaction des hommes ayant des relations sexuelles avec d’autres hommes (HARSAH). In: 5^e conference francophone VIH/SIDA, Casablanca, 28–31 March 2010.

13.

Lessard D, Lebouché B, Vassal A, et al. L’Actuel sur rue. In: CATIE forum: new science, new directions in HIV & HCV, Toronto, Canada, 17–19 September 2013.

14.

Thorton

Delpech

Kall

. HIV testing in community settings in resource-rich countries: a systematic review of the evidence. HIV Med 2012; 13: 416–426.

15.

Holt

. Rapid HIV testing: a literature review, Australia: Australian Federation of AIDS Organisations Inc, 2009.

16.

Meulbroek

Ditzel

Saz

. BCN Checkpoint, a community-based centre for men who have sex with men in Barcelona, Catalonia, Spain, shows high efficiency in HIV detection and linkage to care. HIV Med 2013; 14(Suppl. 3): 25–28.

17.

Thiboutot

Fleury

Steben

. Le dépistage du VIH dans les points de service à l’aide de trousses de dépistage rapide, Québec: INSPQ, 2009.

18.

Fielding

Lindegger

Pedersen

. Evaluation findings from the pilot phase of BC’s provincial point of care HIV testing program: the first 18 months, British Columbia: BC Centre for Disease Control, 2013.