Offering rapid HIV tests in community settings does attract a proportion of people who’ve never gone to a GUM clinic for a test, the 8th AIDS Impact Conference heard this week.
However it does not so far seem to be encouraging a higher proportion of people to test early and to shorten the time between infection and diagnosis, which was one of the hopes when the testing programme was started.
Peter Weatherburn, Director of Sigma Research, told the conference that a quarter of the gay men who used the ‘FasTEST’ programme had never taken an HIV test before and nearly half of the heterosexual people.
The programme was funded by the Department of Health and involved Sigma as researchers and evaluators and the Terrence Higgins Trust as the primary HIV service provider involved. Test programmes were put on at the THT centres in Brighton, Bristol and Leeds, Notting Hill and Lambeth in London, and also at the non-THT Peckham Pulse health centre in SE London.
The test involves pricking a fingertip for a drop of blood, and a result is ready within 15-20 minutes.
During the pilot programme, 1721 tests were performed and 50 people (2.9%) were diagnosed with HIV. The highest HIV rate was 7%, amongst African women, and the second-highest 4.8%, in UK white gay men. The rapid test gave one false-positive result (0.058%), shown to be negative in a second test, but six of the 50 people who tested positive with the rapid test did not return for follow-up appointments and a confirmatory test.
Weatherburn speculated that some of these were people who already know they had HIV but were hoping by some miracle that they’d become negative.
A representative subsample of the testers was interviewed. Half of those testing were gay men and of the remained 57% were women. Tqwenty-six per cent of the gay men had never tested before, 46% of the women, and 48% of the heterosexual men.
When asked why they hadn’t tested at a clinic, half of the testers said they liked the fact that they got the result at the same visit and a third said it was more convenient. One in six said they’d had difficulty getting a GUM clinic appointment, and one in eight said they didn’t know where else to get an HIV test – this especially applied to young testers and to migrants.
A quarter of the gay men and one in 20 of the women said they’d had sex with someone they knew had HIV, but none of the heterosexual men.
A comparison with patients testing at the GUM clinics in Bristol, Brighton and London showed that people using FasTEST were less likely to have ever tested for HIV before or, if they had, less recently. The FasTEST users tended to e younger than clinic testers but in other ways such as their ethnic and sexuality makeup were no different.
FasTEST users were much worse than clinic users about predicting if they were HIV positive. FasTEST users were more likely to expect that they’d get a positive result than clinic users but in fact less likely to receive one, and there was no correlation between those who expected to be positive and those who actually were; the ones that expected to have HIV largely didn’t and the ones that were positive by and large hadn’t expected it.
Disappointingly, the FasTEST programme didn’t seem to be catching people earlier, or at least not so far. The average CD4 count amongst those testing positive was 350-400, about the same as the average for clinic testers, and about one in five had a CD4 count under 200, Both of these figures are comparable with clinics.
“FasTESTs don’t diagnose people earlier,” said Weatherburn, “but they do expand choice and increase capacity.”
With acknowledgement to Gay.comAn excerpt of an article by Gus Cairns
6 July, 2007
Body Positive
