Objectives HIV point-of-care testing (POCT) has been available in Manitoba since 2008. This study evaluated the effectiveness of POCT at identifying individuals with previously unknown HIV status, its effects on clinical outcomes and the characteristics of the populations reached.
Methods A retrospective database review was conducted for individuals who received HIV POCT from 2011 to 2014. Time to linkage to care and viral load suppression were compared between individuals who tested positive for HIV using POCT and controls identified as positive through standard screening. Testing outcomes for labouring women with undocumented HIV status accessing POCT during labour were also assessed.
Results 3204 individuals received POCT (1055 females (32.9%) and 2149 males (67.1%)), being the first recorded HIV test for 2205 (68.8%). Males were more likely to be targeted with POCT as their first recorded HIV test (adjusted OR (AOR) 1.40). Between the two main test sites (Main Street Project (MSP) and Nine Circles Community Health Centre), MSP tested relatively fewer males (AOR 0.79) but a higher proportion of members of all age groups over 30 years old (AOR 1.83, 2.51 and 3.64 for age groups 30–39, 40–49 and >50, respectively). There was no difference in time to linkage to care (p=0.345) or viral load suppression (p=0.405) between the POCT and standard screening cohorts. Of 215 women presenting in labour with unknown HIV status, one was identified as HIV positive.
Conclusions POCT in Manitoba has been successful at identifying individuals with previously unknown HIV-positive status. Demographic differences between the two main testing sites support that this intervention is reaching unique populations. Given that we observed no significant difference in time to clinical outcomes, it is reasonable to continue using POCT as a targeted intervention.
MeSH terms HIV infection; rapid HIV testing; vertical infectious disease transmission; community outreach; service delivery; marginalised populations.
- HIV testing
- service delivery
- outreach services
- antenatal HIV
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Handling editor Jackie A Cassell
Contributors JBJ was responsible for the chart review, data extraction, data collation, basic data analysis, writing and preparing the manuscript and formatting the tables and figure. JLW was responsible for statistical analysis of demographic data and contributed to the methods section. JB provided background information and access to HIV testing records and POCT site records through his capacities as associate medical director of CPL and his involvement in the HIV POCT Program in Manitoba. JB and JJNR were responsible for the original idea for this research project. All authors provided edits to the draft manuscript, and read and approved the final manuscript. Roy Cole was responsible for the creation of the study databases, using information available to Cadham Provincial Lab. Stella Leung performed Wilcoxon and Kaplan-Meier analysis on time to linkage to care and time to viral load suppression data.
Competing interests None declared.
Ethics approval University of Manitoba Bannatyne Campus Research Ethics Board (HREB Approval: H2015104).
Provenance and peer review Not commissioned; externally peer reviewed.