To reduce late HIV diagnosis and to increase the number of individuals who are aware of their serostatus all initiatives that promote access to HIV testing should be encouraged. HIV testing might be increased by using rapid tests, and rapid tests use is particularly applicable in specific nonclinical settings. Oral fluid rapid tests also have the advantage of not requiring a blood sample, reducing the risk of blood exposure.
To implement HIV rapid testing outside traditional clinical settings, Anlaids Lazio Onlus, in collaboration with the National Institute for Infectious Diseases L. Spallanzani, has activated an outreach HIV rapid testing program at its headquarters located in Rome, near the Termini Station, a central place of great affluence and, also, with “anonymous “characteristics, able to encourage access of people who wish to take the test with confidence.
Material and methods
The service has been active since January 2017, twice a month, from 4 to 7 p.m. An anonymous HIV rapid test on oral fluid (OraQuick®; Orasure Technologies) is offered by appointment. Each individual presenting to the service receives pre- and post-test counselling, and is asked to fill out a risk assessment questionnaire. In case of reactive result individuals are referred to the Spallanzani HIV counselling and testing site for confirmatory testing and medical care. The service team is composed of an infectious diseases specialist, a psychologist and a social worker.
During the first quarter of the program (January-March 2017), 82 individuals (58 males) asked to be tested. Median age was 35 years (IQR 27-45); female individuals were significantly younger than males (median age 30 yy vs. 36 yy, p<0.05). All but four were Italians. Among 58 male individuals, 40 were men having sex with men (MSM), 18 reported heterosexual contacts as risk factor; 23 out of 24 women reported sex with men and 1 reported sex with women. 62/82 individuals reported risk behaviors (unprotected intercourses or condom breakage). 28/82 (34.2%) were never tested before; males and MSM reported to be tested more frequently than women and heterosexuals (76% vs. 33%, and 85% vs. 46%, respectively, p<0.001). A previous sexually transmitted infection, other than HIV, was reported by 19 individuals.
A 75 old individual, MSM, had a preliminary positive result. During the post-test counselling the man declared to be aware of his serostatus and to be treated for the HIV infection since more than 10 years.
The program, implemented by the collaboration between ANLAIDS Lazio ONLUS and the National Institute for infectious Diseases L. Spallanzani, has been representing an additional opportunity to be tested for HIV, rapidly, outside clinical setting, in a venue easily accessible from all over Rome. The oral fluid test demonstrated to be accurate, and simple to use in such an informal and confidential environment, suitable for every kind of people.