Background In British Columbia (BC), Canada, new HIV testing guidelines introduced in 2014 recommended routine offer of HIV testing in an effort to diagnose HIV earlier. We assessed changes in motivation and setting for HIV testing that resulted in a new diagnosis of HIV to evaluate this strategy.

Methods In 2013, questions about who initiated testing (provider, client, or other/unknown), test setting (healthcare, community [e.g. outreach, peer], or other), and reason for testing (e.g. recent risk event, routine test, diagnosed with another sexually transmitted or bloodborne infection [STIBBI]) were added to the HIV case report form. Trends from 2003 to 2017 were assessed using Cochran-Armitage tests. HIV testing volumes were determined from the provincial laboratory, which performs >95% of all HIV tests in BC.

Results HIV testing increased from 223,300 episodes in 2013 to 337,900 in 2017. New diagnoses of HIV decreased from 265 in 2013 to 186 in 2017 (cumulative total 1,193). An increasing trend was noted for reporting testing in a healthcare setting compared to community or other settings (p<0.01), especially among men who have sex with men (p<0.01) and people who inject drugs (p<0.01). Provider initiated testing was reported by half of all new HIV diagnoses and remained stable (p=0.86). There was a decreasing trend for reporting recent risk event/exposure (p=0.03) and being notified as a contact (p=0.01) as the reason for testing, and an increasing trend for reporting being diagnosed with another STIBBI (p=0.03). There was no trend in reporting the reason for testing as routine test (p=0.74).

Conclusion Routine offer of HIV testing may be increasing the proportion of HIV diagnosed in healthcare settings. The increase in proportion of new HIV diagnoses due to diagnosis of another STIBBI highlights the importance of co-testing of HIV and other STIBBIs.

Disclosure No significant relationships.