Feasibility and Success of Hiv Point-of-Care Testing in an Emergency Department in an Urban Canadian Setting

Author:

Becker Marissa L12,Thompson Laura H1,Pindera Carla23,Bridger Natalie4,Lopez Carmen5,Keynan Yoav26,Bullard Jared57,Van Caseele Paul57,Kasper Ken28

Affiliation:

1. Centre for Global Public Health, University of Manitoba, Winnipeg, Manitoba, Canada

2. Manitoba HIV Program, Winnipeg, Manitoba, Canada

3. Nine Circles Community Health Centre, Winnipeg, Manitoba, Canada

4. Memorial University of Newfoundland, St John’s, Newfoundland and Labrador, Winnipeg, Manitoba, Canada

5. Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada

6. Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada

7. Cadham Provincial Laboratory, University of Manitoba, Winnipeg, Manitoba, Canada

8. Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

Abstract

BACKGROUND: Approximately 26% of Canadians living with HIV are unaware of their status. Point-of-care (POC) HIV tests have been introduced to simplify and expand HIV testing.OBJECTIVE: To evaluate the feasibility and acceptability of POC testing in an emergency department (ED) setting in Winnipeg, Manitoba.METHODS: A cross-sectional study of unselected adults presenting to the ED at the Health Sciences Centre Hospital (Winnipeg, Manitoba) was performed. Study procedures included pre- and post-test counselling, administration of the INSTI HIV-1/HIV-2 Antibody Test (bioLytical Laboratories, Canada) and a brief questionnaire. Venous blood samples were collected from participants for confirmatory testing on all reactive and indeterminate specimens.RESULTS: In total, 501 adults participated in the study. The majority of participants were younger than 40 years of age, approximately one-half (48.5%) were women and 53% self-identified as Aboriginal. Nearly one-half (49.1%) of the participants had undergone previous HIV testing, although 63% of these tests were performed more than a year earlier. A total of seven individuals tested reactive with the POC test, all of whom were confirmed positive using serological testing (1.4%) and were linked to an HIV specialist within 24 h. Nearly all of the participants (96%) reported satisfaction with the test and believed it belonged in the ED (93%).CONCLUSIONS: Of the participants tested, 1.4% tested reactive for HIV, which is significantly higher than the reported prevalence in Manitoba and in other similar studies conducted in North America. Furthermore, all individuals were linked to timely care. The present study demonstrated that this particular busy tertiary care ED is an important and feasible location for HIV POC testing.

Publisher

Hindawi Limited

Subject

Infectious Diseases,Microbiology (medical)

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