title: Widening the Access to HIV Testing: The Contribution of Three In-Pharmacy Testing Programmes in Spain.
abstract: OBJECTIVE
  Spain has implemented several in-pharmacy HIV testing programmes performed by pharmacists as part of their everyday routine. We aim to assess the feasibility and the main outcomes of three programmes implemented in three Spanish regions with different sociological profiles and also different epidemiology for HIV.
  
  
  METHODS
  The characteristics of the 24151 people tested between 2009 and 2013 at 74 urban pharmacies are studied. We compare the main outcomes of the programmes with those of each Regional HIV Surveillance System (RHSS) assessing the contribution to the total new diagnosis in each region and if priority groups are being reached.
  
  
  RESULTS
  45.7% were heterosexual men (MSW), 14.4% men who have sex with men (MSM), and 27% women. The 35% were younger than 30 and 9.6% foreigners. The 52% were previously untested, and women were the most likely to be untested. The three programmes altogether diagnosed 226 people, resulting in a global prevalence of 0.9% (95%CI: 0.8-1.1); 3.4% in MSM (95%CI: 2.8-4.0). The prevalence among Spaniards was 0.8% (0.7-1.0) vs. 2.2 (1.6-2.9) among foreigners. The percentages of MSM diagnosed by all three programmes were higher than the one reported by their respective RHSS. Thirty four percent of the reactive MSM and the 71.4% of the reactive MSW did not have a previous HIV test although big testing history differences were observed across the programmes. Altogether, these services contributed with the 10.6% of all HIV diagnoses in these regions.
  
  
  CONCLUSIONS
  In-pharmacy HIV testing programmes are a valuable testing option, having been able to uncover 1 out of 10 the new diagnoses reported in each region. They showed a good capacity of reaching and diagnosing previously untested populations, not only a priority population such as MSM but also heterosexual population who are more affected by delayed diagnosis. They seem to be particularly suitable for regions without large cities and specific HIV diagnostic services.
authors.affiliation: National School of Health, Carlos III Health Institute, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Madrid, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Fernández-Balbuena
authors.affiliation: National School of Health, Carlos III Health Institute, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Madrid, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Belza
authors.affiliation: Plan for prevention and control of AIDS and STIs, Basque health service, San Sebastian, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Zulaica
authors.affiliation: Section of surveillance, prevention and control of STIs and HIV, Office of surveillance and response to public health emergencies, Public health agency of Catalonia, Department of health of the regional government of Catalonia, Barcelona, Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Martinez
authors.affiliation: Epidemiological Surveillance Service, Public Health Directorate, Regional Ministry of Health of Castilla and León, Valladolid, Spain.
authors.forename: Henar
authors.initials: H
authors.lastname: Marcos
authors.affiliation: Section of surveillance, prevention and control of STIs and HIV, Office of surveillance and response to public health emergencies, Public health agency of Catalonia, Department of health of the regional government of Catalonia, Barcelona, Spain.
authors.forename: Benet
authors.initials: B
authors.lastname: Rifá
authors.affiliation: Plan for prevention and control of AIDS and STIs, Basque health service, San Sebastian, Spain.
authors.forename: Arantxa
authors.initials: A
authors.lastname: Arrillaga
authors.affiliation: National Epidemiology Centre, Carlos III Health Institute, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: de la Fuente
authors.affiliation: Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Hoyos
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D010594:Pharmacies; D015995:Prevalence; D013030:Spain / Q000453:epidemiology; D055815:Young Adult