Article Text
Abstract
Introduction Acute HIV infection (AHI) is associated with high HIV viral load and therefore an important factor in onward transmission. Timely detection and treatment of AHI can contribute to a better HIV prognosis and help prevent further transmission.
Methods A media campaign directed men to an online intervention (hebikhiv.nl) where visitors were trained in recognising AHI-symptoms and offered an interactive risk-assessment questionnaire using a risk score algorithm comprising behaviour and symptoms. If found at risk, men were referred to the Amsterdam STI clinic for AHI testing including a point-of-care HIV RNA test. If diagnosed with AHI, counselling and referral for immediate treatment was offered. Participation was monitored using web-statistics, and men presented for testing were questioned regarding their referral source.
Results From Aug 2015 to Dec 2016, the intervention’s website was visited 1 50 035 times by 1 27 394 unique visitors. The online risk-assessment tool was started 96 756 times and was completed in 81% (77,949) of the cases. Of those, 10% (7733) received the advice to test for AHI, and of those, 21% (1609) downloaded the referral letter to the STI clinic. At the clinic, 209 men presented for AHI testing. Of those 57% (119) were confirmed to have arrived through the campaign. In total, 181 were eligible for testing, and in 7% (13) AHI was diagnosed. Of the 13 AHI cases, 2 were referred by the campaign, 5 by the STI clinic, 4 through own initiative, 1 by ‘others’, and none by a GP. All 13 were referred to start treatment within 24 hours.
Conclusion The AHI campaign succeeded in engaging a large number of MSM. The high numbers that completed the risk-assessment tool points at an in-depth engagement with the intervention’s material. While most men online were not found to be at risk for AHI, their engagement with the intervention could assist them to self-identify AHI in the future. The mix of referral sources among those diagnosed with AHI points at the added value of establishing a dedicated AHI testing service to attract risk cases in the community.