The Rapid HIV Test in Spanish Pharmacies: A Novel Program to Reach Heterosexual Men?
OBJECTIVES:
Spain
has been a pioneer in the implementation of rapid HIV testing programmes in
pharmacies to increase access to testing. However, no formal evaluation of the
effectiveness of these programmes has been carried out to date. Our aim was to
evaluate the ability of a novel in-pharmacy rapid HIV testing programme to
promote diagnosis and reach vulnerable populations.
METHODS:
Between
2011 and 2012, 2168 people underwent testing in 16 urban pharmacies in 10
cities of a Spanish region with a low prevalence of HIV infection. The main
outcomes of the programme were compared with those of the regional surveillance
system for new HIV diagnoses (RHSS-CyL).
RESULTS:
Overall,
52.8% of those tested were heterosexual men, 15.8% were men who have sex with
men (MSM) and 25.3% were women. Nine per cent were immigrants and 41.9% were
< 30 years old. In total, 59.5% of the heterosexual men, 44.6% of the MSM
and 65.3% of the women were previously untested. There were 23 positive
results, representing 6% of all new regional diagnoses in 2011. The global
prevalence was 1.1% (95% confidence interval 0.6-1.5%) and the prevalence in
MSM was 3.8%. Of the reactive results, 60.9% were in MSM, 34.8% in heterosexual
men and only 4.3% in women, vs. 35.4%, 37.5% and 15.0%, respectively, reported
by the RHSS-CyL. The mean age of those testing positive was 32.7 years vs. 38.7
years in the RHSS-CyL. Fifty per cent of MSM and 75% of heterosexual men
testing positive were previously untested.
CONCLUSIONS:
In
Spain, this is the first programme not targeted at the most at-risk
populations, and has been shown to be effective in reaching and diagnosing
heterosexual men, who are the group most affected by delayed diagnoses.
Heterosexual men accounted for over half of those tested and a third of those diagnosed,
and most of them were previously untested. Young and previously untested MSM
also greatly benefitted from the programme.
- 1National Epidemiology Centre, Carlos III Health Institute, Madrid, Spain.
- 2CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
- 3Epidemiological Surveillance Service, Public Health Directorate, Regional Ministry of Health of Castilla and León, Valladolid, Spain.
- 4National School of Health, Carlos III Health Institute, Madrid, Spain.
- HIV Med. 2015 Jul;16(6):362-9. doi: 10.1111/hiv.12224. Epub 2015 Feb 17.
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