title: Feasibility and success of HIV point-of-care testing in an emergency department in an urban Canadian setting.
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.
authors.affiliation: Centre for Global Public Health, University of Manitoba, Winnipeg, Manitoba; ; Manitoba HIV Program, Winnipeg, Manitoba;
authors.forename: Marissa L
authors.initials: ML
authors.lastname: Becker
authors.affiliation: Centre for Global Public Health, University of Manitoba, Winnipeg, Manitoba;
authors.forename: Laura H
authors.initials: LH
authors.lastname: Thompson
authors.affiliation: Manitoba HIV Program, Winnipeg, Manitoba; ; Nine Circles Community Health Centre, Winnipeg, Manitoba;
authors.forename: Carla
authors.initials: C
authors.lastname: Pindera
authors.affiliation: Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Winnipeg, Manitoba;
authors.forename: Natalie
authors.initials: N
authors.lastname: Bridger
authors.affiliation: Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba;
authors.forename: Carmen
authors.initials: C
authors.lastname: Lopez
authors.affiliation: Manitoba HIV Program, Winnipeg, Manitoba; ; Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba;
authors.forename: Yoav
authors.initials: Y
authors.lastname: Keynan
authors.affiliation: Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba; ; Cadham Provincial Laboratory, University of Manitoba, Winnipeg, Manitoba;
authors.forename: Jared
authors.initials: J
authors.lastname: Bullard
authors.affiliation: Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba; ; Cadham Provincial Laboratory, University of Manitoba, Winnipeg, Manitoba;
authors.forename: Paul
authors.initials: P
authors.lastname: Van Caseele
authors.affiliation: Manitoba HIV Program, Winnipeg, Manitoba; ; Department of Medicine, University of Manitoba, Winnipeg, Manitoba.
authors.forename: Ken
authors.initials: K
authors.lastname: Kasper
keywords: Emergency departments; HIV; Testing