Community-based rapid HIV testing in homeless and marginally housed adults in San Francisco.
BACKGROUND
Standard two-step HIV testing is limited by poor return-for-results rates and misses high-risk individuals who do not access conventional testing facilities.


METHODS
We describe a community-based rapid HIV testing programme in which homeless and marginally housed adults recruited from shelters, free meal programmes and single room occupancy hotels in San Francisco received OraQuick Rapid HIV-1 Antibody testing (OraSure Technologies, Bethlehem, PA, USA).


RESULTS
Over 8 months, 1614 adults were invited to participate and 1213 (75.2%) underwent testing. HIV seroprevalence was 15.4% (187 of 1213 individuals) overall and 3.5% (37 of 1063) amongst high-risk individuals reporting no previous testing, a prior negative test, or previous testing without result disclosure. All 1213 participants received their results. Of 30 newly diagnosed persons who received confirmatory results, 26 (86.7%) reported at least one contact with a primary healthcare provider in the 6 months following diagnosis.


CONCLUSIONS
We conclude that community-based rapid testing is feasible, acceptable and effective based on the numbers of high-risk persons tested over a short period, the participation rate, the prevalence of new infection, the rate of result disclosure, and the proportion linked to care.
Buchér
J B
JB
University of California, San Francisco (UCSF) School of Medicine, San Francisco, CA 94143, USA.
Thomas
K M
KM
Guzman
D
D
Riley
E
E
Dela Cruz
N
N
Bangsberg
D R
DR
D000293:Adolescent; D000328:Adult; D003153:Community Health Services; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology; D015528:HIV Seroprevalence; D006297:Health Services Accessibility; D006703:Ill-Housed Persons; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D012111:Residence Characteristics; D012495:San Francisco / Q000453:epidemiology; D014504:Urban Health; D019037:Urban Health Services