HIV self-testing strategies have been recommended by the World Health Organization (WHO) since 2016, because they provide people with the opportunity to learn about HIV status at their discretion. Homemade test kits are not yet approved for sale in Canada. However, a team from McGill University Health Research Institute (RI-MUHC) and employees of Clinique Médicale l & Actuel in Montreal rated a self-testing testing program without control through an application for smartphones and tablets called HIVSmart! men who have sex with men). The results of their research – the first in Canada – were published online this week in Journal of Medical Internet Research,
“To achieve the first 95 targets set by UNAIDS 95-95-95 by 2030, it is imperative that we help identify HIV in those who live unaware of their HIV status. The screening strategy that has the potential to achieve undiagnosed is HIV self-diagnosis, ”says Dr. Nitika Panth Pay, lead author of this study, and researcher of infectious diseases and immunity in the global RI-MUHC health program and associate professor of medicine at McGill University. “HIVSmart! drowns out all the gaps in the process of self-testing; it works with any approved HIV testing, makes testing easier and proactively informs the user. ”
“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 earlier, ”adds Dr. Régina Thomas, co-author of the study, who is also the founder and CEO of Clinique Médicale L & 39; Actuel,“ An app such as HIVSmart! increases the availability of testing, especially outside large cities, where it is sometimes more difficult to get tested due to confidentiality issues.
HIVSmart! Available for smartphones, tablets or web applications (Android, iPhone and iPad) that were developed by Dr. Pant Pye and her team at RI-MUHC. It informs, interprets and stores data confidentially, but, most importantly, it quickly connects users with counseling or custody and encourages the user to remain in care. Originally developed with financial support from Grand Challenges Canada, HIVSmart! was evaluated in Montreal by this study, funded by the Canadian Institutes for Health Research (CIHR).
HIVSmart! feasibility in montreal
Between July 2016 and February 2017, researchers conducted a study of 451 men who have sex with men (sometimes called MSM) between the ages of 18 and 73, who presented themselves at Clinique Médicale L & # 39; Actuel for HIV testing . They were offered an HIV test based on native saliva and a tablet equipped with HIVSmart! Application. The strategy emulated testing in an unsupervised home environment. Using HIVSmart!, Participants completed a self-study course, learned how to perform and interpret a test, store results and quickly receive help.
“Our research shows that HIVSmart! The application strategy is possible, accepted and preferred by the educated urban population of MSM in Montreal, ”says Dr. Pant Pay. “As a strategy, it is suitable for those who prefer to test themselves at their discretion in a comfortable room in a private space, such as their home, office or kiosks. This makes it possible!
HIV self-testing for at-risk groups
In Canada, the HIV epidemic is disproportionately represented in key populations, such as MSM, injecting drug users, Aboriginal people and immigrants from HIV-endemic countries. Approximately 18 to 25 percent of Canadian MSM are unaware of their HIV-positive status, and their numbers can be proportionately higher for IDUs, indigenous people, and immigrants, which emphasizes the need for affordable HIV self-testing services.
“We currently have every opportunity to eradicate HIV. HIVSmart! The app is a way to support patient autonomy, ”says Dr. Thomas. “Promoting screening reduces the number of people who do not know their HIV status, quickly puts HIV-positive people on treatment, so their viral charge becomes undetectable and, ultimately, eradicates HIV.”
Researchers plan to adapt HIVSmart! self-test strategies for many at-risk groups in Canada and around the world, thereby maximizing the public health impact. HIVSmart! The strategy is also being pursued in South Africa.
* UNAIDS Rapid Response Strategy to Fight 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 sustainable antiretroviral therapy.
By 2030, 95% of all people receiving antiretroviral therapy will have suppressed the virus.
- 84.7% were educated outside high school;
- 79.5% Was used;
- 52.5% have been tested in the last 6 months.
- 99.3% participants who independently tested negative and received consultations after testing them;
- 0.7% of the participants who were self-positive and were laboratory-confirmed, were associated with a physician on the same day;
- 98.8% participants found the app useful;
- 94% participants were willing to recommend it to a friend or partner.
About the study
Pant Pai N, Smallwood M, Desjardins L, Goyette A, Birkas KG, Vassal AF, Joseph L, Thomas R
An unsupervised smart application-optimized HIV self-monitoring program in Montreal, Canada: a cross-sectoral research study
J Med Internet Res 2018; 20 (11): e10258
DOI: 10.2196 / 10258
This work was funded by the Canadian Institutes of Health Research (CIHR) and the De Quebec-Sante Foundation (FRQS).
Contact for media:
McGill University Health Center
Julie [dot] Robert [at] muhc [dot] Mcgill [dot] California