title: Assessment of an outreach street-based HIV rapid testing programme as a strategy to promote early diagnosis: a comparison with two surveillance systems in Spain, 2008-2011.
abstract: We assess the added value of a multisite, street-based HIV rapid testing programme by comparing its results to pre-existing services and assessing its potential to reduce ongoing transmission. Between 2008 and 2011, 8,923 individuals underwent testing. We compare outcomes with those of a network of 20 sexually transmitted infections (STI)/HIV clinics (EPI-VIH) and the Spanish National HIV Surveillance System (SNHSS); evaluate whether good visibility prompts testing and assess whether it reaches under-tested populations. 89.2% of the new infections were in men who have sex with men (MSM) vs 78.0% in EPI-VIH and 56.0% in SNHSS. 83.6% of the MSM were linked to care and 20.9% had <350 CD4 HIV prevalence was substantially lower than in EPI-VIH. 56.5% of the HIV-positive MSM tested because they happened to see the programme, 18.4% were previously untested and 26.3% had their last test ≥2 years ago. The programme provided linkage to care and early diagnosis mainly to MSM but attendees presented a lower HIV prevalence than EPI-VIH. From a cost perspective it would benefit from being implemented in locations highly frequented by MSM. Conversely, its good visibility led to reduced periods of undiagnosed infection in a high proportion of MSM who were not testing with the recommended frequency.
authors.affiliation: Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Belza
authors.forename: J
authors.initials: J
authors.lastname: Hoyos
authors.forename: S
authors.initials: S
authors.lastname: Fernández-Balbuena
authors.forename: A
authors.initials: A
authors.lastname: Diaz
authors.forename: M J
authors.initials: MJ
authors.lastname: Bravo
authors.forename: L
authors.initials: L
authors.lastname: de la Fuente
mesh_terms: D000328:Adult; D042241:Early Diagnosis; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008952:Mobile Health Units; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D015397:Program Evaluation; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data; D013030:Spain / Q000453:epidemiology