Incorporation of Rapid Test at a University Hospital STD Clinic increased HIV and syphilis detection. Effect on linkage to care.

MORANDO N; RODRÍGUEZ FERMEPIN M; GALLO VAULET L; MELGAR A; CASCO R; PANDO MÁ

Chicago

Conferencia; HIV Research for Prevention; 2016

Global HIV Vaccine Enterprise

Access to diagnosis and inclusion in care have been recognized as keystrategies for HIV/AIDS control. Rapid testing (RT) for HIV and Syphilis wererecommended in Argentina for diagnostic purposes. The aim of this study was toevaluate the utility of the implementation of RT for HIV and Syphilis in asexually transmitted diseases clinic (STD) and their impact on linkage to care.Between March and December 2015, RTfor HIV and Syphilis was offered for the first time at the University HospitalSTD clinic to every patient. Finger-prick RT for HIV and Syphilis wereperformed (Alere Determine HIV-1/2; Alere Determine Syphilis TP). Complementarystudies (ELISA, viral load and CD4 T cell count) were offered to HIV Reactiveparticipants. VDRL test was offered to every participant.A total of 30.9% of patientsattending the clinic agreed to test for HIV, showing a significant increasecompared to the previous year (6.9%, p<0.001). During the study, 583 HIV RTand 586 Syphilis RT were performed, yielding a prevalence of 5.8% (95%CI 3.8-7.8)and 30.0% (95%CI 26.2-33.8), respectively. Co-infection was detected in 2.8% ofcases. Participants with reactive syphilis RT were more likely to go to the laboratoryfor VDRL testing (94.3% vs. 79.8%, p<0.001). Among participants with reactiveHIV RT, 94.1% (32/34) attended the lab for complementary studies, confirminginfection in 93.8% (30/32) of them and 87.5% (28/32) retrieved results. A totalof 30% (175/583) of participants were never tested for HIV, being this frequencyhigher among those who had no linkage to the health system over the past year(40.3% vs. 26.3%, p<0.01). Among the former, inconsistent condom use wasfrequently reported (83% vs. 71.4%, p=0.005) as well as higher prevalence ofHIV infection (9.1% vs. 4.5%, p<0.05). The results of the study show the positiveimpact of the implementation of RT on diagnosis of HIV and syphilis andefficacy in linkage to care.