Pilot of non-invasive (oral fluid) testing for HIV within a community setting Joseph Debattista* (1), Shaun Staunton (2), Frances Birrell (3), Nicole Roudenko (4), Bill Rutkin (5), Craig Davis (3) Brisbane Sexual Health & AIDS Service, Northside Health Service District (1); Queensland Association for Healthy Communities (2), Communicable Diseases Branch, Queensland Health (3), Division of Immunology, Queensland Health Pathology Services, Royal Brisbane & Women’s Hospital (4), Sexual Health, HIV and HCV Coordinator (Southern Area, Toowoomba Health Service
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Pilot Of Non Invasive (Oral Fluid) Testing For HIV Within A Community Setting
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Pilot of non-invasive (oral fluid) testing for HIV within a
community setting
Joseph Debattista* (1), Shaun Staunton (2), Frances Birrell (3), Nicole Roudenko (4), Bill Rutkin (5), Craig
Davis (3) Brisbane Sexual Health & AIDS Service, Northside
Health Service District (1); Queensland Association for Healthy Communities (2), Communicable Diseases
Branch, Queensland Health (3), Division of Immunology, Queensland Health Pathology Services, Royal Brisbane & Women’s Hospital (4), Sexual Health, HIV and HCV
Coordinator (Southern Area, Toowoomba Health Service
District) (5) Brisbane, Queensland, Australia.
Community response
• The community response very positive
• Originally planned to do two weeks worth of recruiting, but less than one week was needed
• 64 sessions were originally pencilled
in/only 32 sessions were needed
Identifying Recruiting Issues
• Recruiters noted that the majority of rejections were from young guys
• People in couples and groups seemed reluctant to take part due to others being around them (being in a group situation)
• People also refused on the grounds that they already knew their status
(positive and negative)
Test Results
• Participants didn’t get their HIV test results back
• To minimise any harms;
– Study pre-promotion
– Flyers about testing
– Sexual health clinic referrals
– Fast track blood testing process
– Health promotion staff available
– The study results released
Thanks to Frances Birrell from Communicable Diseases Branch, Queensland Health, for the following statistics and statistical analyses
Outline
• The study• Questions of interest• Test results profile• Participant characteristics• Risk factors• Limitations
Some Points about the Study
• Cross sectional (convenience sample)• 465 patrons from 7 venues
– Wet and dry SOPVs– Pubs/clubs
• Refusal: 24% - 42% across all venues• Occurred in Brisbane and Toowoomba
Questions of interest
• Among participants
– Prevalence of HIV
– Level of undiagnosed HIV infection
– Risk factors & testing patterns associated with serostatus
Subgroups – Reported status
• HIVpp – Reported self as being HIV positive/tested HIV positive (33 people)
• HIVnn – Reported self as being HIV negative/tested as being HIV negative (424 people)
• HIVnp – Reported self as being HIV negative/tested as being HIV positive (8 people)
HIV Prevalence (test results profile)
• 41participants ELISA positive/ Western Blot positive– 33 self reported as positive (HIVpp)
– 8 self reported as negative (HIVnp)
• 41/465=8.8% of total participants were HIV positive
• 8/465=1.7% participants (overall) were HIV positive and didn’t know
• 8/432=1.9% of those with negative self report were test positive
• 8/41 = 19.5% of people who were HIV positive didn’t know it
• HIVpp: 67% tested with in last 6 months • HIVnn: 50% tested with in last 6 months• HIVnp all had test with in last 2 years (86% with in 6 months) - recent acquisition
Risk Factor Odds Ratio 95% Confidence Intervals p value
Attends SOPV 2.04 0.93 to 4.43 0.06
Unprotected sex with regular partner 0.71 0.29 to 1.62 0.38
Unprotected sex with casual partner 2.24 0.98 to 5.00 0.03
Knew HIV status of regular partner 25.93 8.28 to 79.70 0.00
Knew HIV status of casual partner 13.19 3.88 to 43.00 0.00
Informed regular partner of HIV status 2.91 1.06 to 9.92 0.03
Informed casual partner of HIV status 3.36 1.30 to 10.20 0.01
Had more than 11 partners in last six months
2.55 1.11 to 5.68 0.01
Limitations
• Cross sectional study • Opportunistic sample (not representative)
– Refusal: 24% to 42%
• Cannot make inferences beyond study group
But• May suggest hypotheses for more robust study
Summary - descriptive
• Median age: HIVpp > HIVnn > HIVnp • Venue type
– Attend SOPV: HIVpp > HIVnn > HIVnp
• Last HIV test– HIVpp: 67% tested within last 6 months (?other bloods tests, recent Dx)– HIVnn: 50% tested within last 6 months– HIVnp all had test within last 2 years (86% within 6 months)
• Partners in last 6 months (≥ 11 partners)– HIVpp: ~40%– HIVnn: ~20%– HIVnp: ~14%
AcknowledgmentsWe gratefully acknowledge the support of the laboratorystaff of the Division of Immunology, QHPS who performedthe assays, the staff and management of the participatingclubs and Sex on Premises Venues, the outreach workersfrom the Queensland Association for Healthy Communities(QAHC) who collected the specimens and patron surveys(Greg Jenner, Ben Wilcock, Michael King, Angela Yin,Susan Gobbart, Jasmine Linton, Mark Herriman, DavidDeloso, Scott Norman), Bill Rutkin for coordinating the Toowoombastudy, Garry Boddy of the CommunicableDiseases Branch, and most importantly, patrons whoGenerously participated. This study was funded by theCommunicable Diseases Branch, Queensland Health.