Since 2016, the World Health Organization (WHO) has recommended HIV testing strategies, as they encourage people to find out their HIV status according to their convenience. Domestic test kits have yet to be approved for sale in Canada. However, a research team at the McGill University Medical Center (RI-MUHC) and associates from Clinique Médicale l'Actuel, in Montreal, assessed the unscheduled self-testing program for HIV through the application of smartphones and tablets called HIVSmart! among the at-risk populations (men who have sex with men). Findings from their study – Canada-First – were published online this week in the Journal of Medical Internet Research.
"To reach the top 95 of the so-called 95-95-95 goals set by UNAIDS * by 2030, it is imperative to help in the detection of HIV in those who live unaware of their HIV status. has the potential to reach undiagnosed self-testing of HIV, "said Dr. Nitika Pant Pai, chief author of the study and researcher of Infectious Diseases and Immunity in the Global Health Program at RI-MUHC and Associate Professor of Medicine at McGill University. "HIVSmart! Joins all the gaps in the self-test process; it works with any approved HIV test, facilitates testing and proactively informs the user."
"By promoting screening, HIVSmart! Can help reduce the number of people living with HIV who do not know their status and allow them to start treatment sooner," added Dr. Regan Thomas, a study co-author, who is also the founder and CEO of Clinique Médicale L & # 39; Actuel. & # 39; & # 39; An application such as HIVSmart! increases accessibility to testing, especially outside large cities, where it is sometimes more difficult to test because of confidentiality issues. "
HIVSmart! is available for smartphones, tablets or web-based (Android, iPhone and iPad) confidential software application developed by Dr. Pant Pai and its RI-MUHC team. It informs, interprets and stores data confidentially, but, most importantly, connects users with counseling or care quickly and encourages the user to remain in care. Originally developed with funding from Grand Challenges Canada, HIVSmart! was estimated in Montreal thanks to this study funded by the Canadian Health Research Institute (CIHR).
HIVSmart! feasibility in Montreal
Between July 2016 and February 2017, the researchers conducted a study of 451 men who had sex with men (sometimes referred to as MSM) aged 18 to 73, who were presented at Clinique Médicale L & # 39; Actuel to be tested for HIV. They were offered a test for HIV based on saliva and a tablet equipped with HIVSmart! App. The strategy mimicked testing in an unprotected home environment. Using HIVSmart!, The participants were guided through the self-test process, teaching how to perform and interpret the test, store the results, and get care quickly.
"Our study shows that the HIVSmart! Application Strategy is feasible, accepted and preferred by an educated, urban MSM population in Montreal," says Dr. Pant Pai. "As a strategy, it suits individuals who prefer to test for their convenience in the comfort of private spaces, such as their home, office or kiosks. That is strengthening!"
HIV self-testing for populations at risk
In Canada, the HIV epidemic is disproportionately represented in key populations such as MSM, injecting drug users, indigenous people and immigrants from HIV-endemic countries. About 18 to 25 per cent of Canadian MSM populations are not aware of their HIV-positive status, and the number can be proportionally higher for IDUs, for indigenous populations and immigrants, which emphasizes the need for affordable HIV self-testing services.
"Currently, we have all the means to eradicate HIV." HIVSmart! The application is a way to support the autonomy of the patient, "said Dr. Thomas. "Promoting screening reduces the number of people who do not know their HIV status, quickly put HIV-positive people on treatment, so that their viral accusation becomes invisible, and, finally, eradicate HIV."
Researchers plan to adapt HIVSmart! a self-test strategy for many risky populations in Canada and the world, thereby maximizing its impact on public health. HIVSmart! the strategy is being tested in South Africa.
UNAIDS fast-track strategy to end AIDS by 2030:
- By 2030, 95% of all people living with HIV will know their HIV status.
- By 2030, 95% of all people diagnosed with HIV will receive sustained antiretroviral therapy.
- By 2030, 95% of all people receiving antiretroviral therapy will have viral suppression.
Profile of the participants
- 84.7% are educated outside high school;
- 79.5% were employed;
- 52.5% were tested for the past 6 months.
- 99.3% of the participants who tested negative and received counseling after their test;
- 0.7% of respondents who are self-positive and confirmed with laboratory findings are associated with a doctor on the same day;
- 98.8% of participants consider the application to be useful;
- 94% of the participants were ready to recommend it to a friend or partner.
– Research Institute of MUHC
-McGill University Health Center