title: Web-Based HIV Testing in Abruzzo, Italy: Analysis of 15-Month Activity Results.
abstract: Undiagnosed cases of HIV infection in developed countries are estimated at 20-30% of individuals living with HIV. Web-based strategies may represent a new approach to easier, wider, and unrestricted access to early testing. The Abruzzo Region, Italy, developed a Web-based tool to recruit persons at high risk of HIV and other sexually transmitted infections (STIs). At the Website www.failtestanchetu.it , browsers found information on STIs (HIV, hepatitis B and C, and syphilis), a structured questionnaire called "risk calculator" to assess one's own risk behaviors and direct booking of their test at one of six sites throughout the region. The Website was advertised on local media and in pharmacies, high schools, sports facilities, and factories. Between February 1, 2014, and May 31, 2015, about 6000 users visited the Website; 3046 people attended a visit for counseling on risk behaviors, signs, or symptoms of STIs and accepted blood drawing for HIV, hepatitis B Virus (HBV), hepatitis C Virus (HCV), and syphilis tests. Fifty-eight (1.90%) subjects were positive for HCV, 56 (1.84%) for HBsAg, 90 (2.95%) for Treponema pallidum antibodies, and 28 (0.92%) for HIV. Ninety-two percent of HIV-positive patients were successfully linked to care. Late presenters were less frequent in this sample than in the population diagnosed with HIV in Italy in 2014. An overall 7% proportion of HIV, HBV, HCV, and syphilis-unaware cases were all transferred to care, with the exception of three people. HIV seropositivity among testers was higher than 2/1000, the cost-effectiveness threshold suggested for effective testing. Therefore, our Web-based unrestricted and free access methodology appears worth further and wider evaluation.
authors.affiliation: 1 Infectious Diseases Unit, Pescara General Hospital , Pescara, Italy .
authors.forename: Ennio
authors.initials: E
authors.lastname: Polilli
authors.affiliation: 1 Infectious Diseases Unit, Pescara General Hospital , Pescara, Italy .
authors.forename: Federica
authors.initials: F
authors.lastname: Sozio
authors.affiliation: 1 Infectious Diseases Unit, Pescara General Hospital , Pescara, Italy .
authors.forename: Paola
authors.initials: P
authors.lastname: Di Stefano
authors.affiliation: 1 Infectious Diseases Unit, Pescara General Hospital , Pescara, Italy .
authors.forename: Antonina
authors.initials: A
authors.lastname: Sciacca
authors.affiliation: 1 Infectious Diseases Unit, Pescara General Hospital , Pescara, Italy .
authors.forename: Tamara
authors.initials: T
authors.lastname: Ursini
authors.affiliation: 2 Infectious Diseases Unit, Avezzano General Hospital , Avezzano, Italy .
authors.forename: Maurizio
authors.initials: M
authors.lastname: Paoloni
authors.affiliation: 3 Infectious Diseases Clinic, University of Chieti , Chieti, Italy .
authors.forename: Jacopo
authors.initials: J
authors.lastname: Vecchiet
authors.affiliation: 4 Infectious Diseases Unit, Teramo General Hospital , Teramo, Italy .
authors.forename: Dante
authors.initials: D
authors.lastname: Di Giammartino
authors.affiliation: 5 Infectious Diseases Unit, Vasto General Hospital , Vasto, Italy .
authors.forename: Maria Pina
authors.initials: MP
authors.lastname: Sciotti
authors.affiliation: 6 Infectious Diseases Unit, L'Aquila General Hospital , L'Aquila, Italy .
authors.forename: Alessandro
authors.initials: A
authors.lastname: Grimaldi
authors.affiliation: 7 Health Department, Pescara General Hospital , Pescara, Italy .
authors.forename: Valerio
authors.initials: V
authors.lastname: Cortesi
authors.affiliation: 8 Microbiology and Virology Unit, Pescara General Hospital , Italy .
authors.forename: Paolo
authors.initials: P
authors.lastname: Fazii
authors.affiliation: 9 Department of Infectious Disease, ASST Fatebenefratelli Sacco , Milan, Italy .
authors.forename: Elena
authors.initials: E
authors.lastname: Ricci
authors.affiliation: 10 General Direction, Pescara General Hospital , Pescara, Italy .
authors.forename: Claudio
authors.initials: C
authors.lastname: D'Amario
authors.affiliation: 11 National Institute for Infectious Diseases Lazzaro Spallanzani , Rome, Italy .
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ippolito
authors.affiliation: 12 Fondazione Onlus Camillo de Lellis per l'Innovazione e la Ricerca in Medicina , Pescara, Italy .
authors.forename: Lucio
authors.initials: L
authors.lastname: Pippa
authors.affiliation: 1 Infectious Diseases Unit, Pescara General Hospital , Pescara, Italy .
authors.forename: Giustino
authors.initials: G
authors.lastname: Parruti
mesh_terms: D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D015528:HIV Seroprevalence; D016174:Hepacivirus / Q000302:isolation & purification; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D020407:Internet; D007558:Italy / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data; D008875:Middle Aged; D012698:Serologic Tests; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control
keywords: AIDS; HIV; STIs testing; late presentation; web testing