Since 2016, the World Health Organization (WHO) recommends a self-testing strategy for HIV, enabling people to find HIV status in their comfort. Home test kits must still be approved for sale in Canada. However, the team at the McGill University Health Center (RI-MUHC) and collaborators from Clinique Media Actal in Montreal evaluated an unnoticed HIV self-test program using a smartphone and tablet application called HIVSmart! risk population (men who have sex with men). The results of the study – Canada – the first – were published online this week Journal of Medical Internet Research.
"To achieve the first 95 so-called 95-95-95 targets set by UNAIDS * by 2030, it is essential that we help to detect HIV in those who are not aware of their HIV status." A screening strategy that has the potential to achieve undiagnosed results is a car -Testing HIV, "says Dr. Nitika Pant Pai, lead author of this study, and a researcher on infectious diseases and immune research in the RI-MUHC Global Health Program. lecturer at McGill University. "HIVSmart! Integrates all gaps in the self-test process, works with any approved autotope of HIV, facilitates testing, and proactively informs users."
"Promoting screening of HIVSmart! Can help reduce the number of people living with HIV who do not know their status and allow them to start treatment earlier," Dr. Réjean Thomas, co-author of the study, who is also the founder and CEO of Clinique Médicale L 'Actuel. & # 39; Applications like HIVSmart! increases accessibility to testing, especially outside major cities, where it is sometimes more difficult to obtain confidentiality tests. "
HIVSmart! is available for smart phones, tablets, or web apps (Android, iPhone, and iPad) developed by Dr. Pant Pai and her team at RI-MUHC. It informs, interprets and stores data intimately, but above all, connects users with advice or care quickly and encourages users to remain in care. Originally developed with funding from Grand Challenges in Canada, HIVSmart! was evaluated in Montreal thanks to this study funded by Canadian Health Research Institutions (CIHR).
HIVSmart! feasibility in Montreal
Between July 2016 and February 2017, researchers conducted a study of 451 men who had sex with men (sometimes referred to as MSM) between the ages of 18 and 73 who presented themselves in the HIV treatment test at Clinique Medicinal Actuel. They were offered an HIV test based on home-based saliva and tablets equipped with HIVSmart technology! Application. The strategy mimicked testing in an uncontrolled home environment. Using HIVSmart !, participants were led by a self-test process, learning how to perform and interpret the test, store results and take care quickly.
"Our study shows that HIVSmart! The application of the strategy is acceptable and preferred by the educated MSM urban population in Montreal," Dr. Pant Pai. "As a strategy, it is suitable for individuals who prefer testing in the comfort of a private space, such as their home, office or kiosks.
HIV self-testing in risky populations
In Canada, the HIV epidemic is over-represented in key populations such as MSM, injecting drug users, indigenous peoples, and immigrants from endemic HIV. Approximately 18 to 25 percent of Canadian MSM populations are unaware of their HIV-positive status and the number may be proportionally higher for IDUs, indigenous populations and migrants, underlining the need for available HIV self-tests.
"We currently have all the means to eradicate HIV." HIVSmart! App is a way to boost patient autonomy, "Dr. Thomas. "Promoting screening reduces the number of people who do not know their HIV status, quickly HIV-positive people on treatment so their viral load becomes undetectable and eventually eradicates HIV."
Scientists plan to adapt HIVSmart! self-testing strategies for many endangered populations in Canada and worldwide, maximizing the impact on public health. HIVSmart! strategy is also tested in South Africa.
* UNAIDS Rapid Awareness Strategy for 2030:
By 2030, 95% of all people living with HIV will know their HIV status.
By 2030, 95% of all people diagnosed with HIV infection will receive antiretroviral treatment.
By 2030, 95% of all people receiving antiretroviral therapy will suppress viral disease.
Profile of participants
- 84.7% were students out of high school;
- 79.5% were used;
- 52.5% has been tested in the last 6 months.
- 99.3% participants who tested negative and received counseling after the test;
- 0.7% participants who tested positively and were positively confirmed on a laboratory basis were contacted on the same day;
- 98.8% participants found the application to be useful;
- 94% participants were willing to recommend it to a friend or partner.
Pant Pai N, Smallwood M, Desjardins L, Goyette A, Birkas KG, Vassal AF, Joseph L, Thomas R
Independent smart-optimized HIV Self-Testing program in Montreal, Canada: Cross-sectional study
J Med Internet Res 2018; 20 (11): e10258
DOI: 10.2196 / 10258
This work was funded by Canadian Health Research Institutions (CIHR) and the Fonds de Recherche du Québec – Santé (FRQS).
McGill University Medical Center
Julia [dot] robert [at] muhc [dot] mcgill [dot] like