HIV point-of-care-testing in Nova Scotia:

Background: Despite decades of HIV prevention efforts, new infections continue in Canada. Access to and ease of HIV testing remains an important element for both HIV prevention and treatment. As it currently stands, HIV testing in Nova Scotia involves accessing a health care provider, non-nominal testing through the STD clinic at the Queen Elizabeth II Health Sciences Centre, or one of two anonymous HIV testing sites. HIV point-of-care-testing (HIV POCT) was first introduced in Canada in 2000. Although HIV POCT is not currently available in Nova Scotia, it has become regarded as a means of increasing HIV testing rates within populations that may not otherwise come forward for conventional HIV testing. Methods: This 8-month pilot project sought to determine the acceptability and uptake of rapid HIV point-of-care testing (POCT) among hard-to-access populations in Halifax, who may be insecurely house, street-involved, currently using injection drugs, or involved in methadone maintenance therapy. Four different outreach settings that are currently established in Halifax were used as testing centers. Results: 305 individuals accessing services at these various sites were offered this test, and 67 individuals accepted. Participants who declined POCT testing cited reasons such as not having enough time, or having bloodwork performed through a physician. Some simply declined without explicitly stating a reason. All tests were found non-reactive, and were confirmed through conventional laboratory testing. The nurse who administered the test indicated that a number of individuals requested POCT testing for HCV. Conclusion: The low uptake rate found in this study reflects, in part, the need to continue to address the basic determinants of health and related social needs of our hard-to-access populations, as well as the demand for HCV/HIV multiplex testing in outreach settings.