Review article
Rapid Point-of-Care HIV Testing in Youth: A Systematic Review

https://doi.org/10.1016/j.jadohealth.2013.07.029Get rights and content

Abstract

Purpose

This review examines the literature surrounding acceptability of, and preference for, rapid point-of-care (POC) human immunodeficiency virus (HIV) testing in youth, documents notification rates when youth were offered rapid POC testing, and identifies the sociodemographic factors associated with testing.

Methods

The reviewers searched the scholarly literature indexed in MEDLINE, Embase, CINAHL, and PsycInfo using a set of keywords related to youth and rapid POC HIV testing. A total of 14 articles were included in the review.

Results

Four themes were identified: (1) Youth will accept rapid POC testing, particularly if offered; (2) youth prefer rapid POC testing to traditional testing; (3) youth receive their rapid POC HIV test results; and (4) older youth and those with HIV risk factors or a concurrent genitourinary diagnosis are more likely to accept rapid POC HIV testing when it is offered.

Conclusions

Evidence shows that youth accept and prefer rapid POC HIV tests when offered. The routine use of rapid POC HIV tests in emergency departments and adolescent primary care clinics should be considered because of higher uptake in these environments. Youth receive their rapid POC test results more frequently and sooner than traditional test results. However, further work is needed to develop HIV testing programs that target younger adolescents.

Section snippets

Methods

The methods described below were developed based on methodologies and recommendations from the Cochrane Handbook for Systematic Reviews of Interventions [26] and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses [27] statement on systematic reviews.

Results

The literature search identified 829 potentially relevant studies after duplicate studies were removed (Figure 1). After full-text analysis of 80 articles, 14 met all inclusion criteria and were included in the qualitative synthesis (Table 1) [21], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39], [40].

These 14 articles included the following methodologies: chart reviews (five studies) [30], [32], [35], [37], [39], surveys (seven studies) [21], [28], [31], [33], [36], [38]

Discussion

This review describes the literature surrounding the preferences and acceptability of rapid POC HIV testing in youth. The literature clearly demonstrates that youth will accept and prefer rapid POC testing. In seven [32], [33], [35], [37], [38], [39], [40] of nine studies [32], [33], [34], [35], [36], [37], [38], [39], [40] the rates of acceptance were ≥50%. When both rapid and traditional HIV tests are available, testing significantly increases with the availability of rapid tests [34]. These

References (40)

  • Facilitating HIV testing and disclosure with children and adolescents. International HIV/AIDS Alliance....
  • J. Inungu et al.

    HIV testing among adolescents and youth in the United States: Update from the 2009 Behavioral Risk Factor Surveillance System

    Open AIDS J

    (2011)
  • National Survey of Teens on HIV/AIDS: Public knowledge and attitudes about HIV/AIDS. Kaiser Family Foundation....
  • E. Lloyd-Smith

    Syringe sharing among young drug users in Vancouver

    Can J Infect Dis

    (2007)
  • Public Health Agency of Canada. Street youth in Canada: Findings from Enhanced Surveillance of Street Youth in Canada,...
  • E. Roy et al.

    HIV incidence among street youth in Montreal, Canada

    AIDS

    (2003)
  • Results from the 2009 National Survey on Drug Use and Health: Volume I. Summary of National Findings. Substance Abuse...
  • HIV among youth in the US: Protecting a generation. CDC Vital Signs....
  • Screening for HIV. US Preventative Services Task Force....
  • S. Flicker et al.

    Sexpress: The Toronto Teen Survey Report. Toronto, ON: Planned Parenthood Toronto

    (2009)
  • Cited by (24)

    • Interventions to enhance testing, linkage to care, and treatment initiation for hepatitis C virus infection: a systematic review and meta-analysis

      2022, The Lancet Gastroenterology and Hepatology
      Citation Excerpt :

      Further work is needed to expand the education and training of HCV care providers, particularly among general practitioners, as HCV treatment restrictions are removed to allow a broadened prescriber base, remove liver disease stage restrictions, and remove restrictions on treatment based on drug and alcohol use,144 and to better understand the impact of provider education on later stages of the care cascade such as linkage to HCV care.145 Point-of-care antibody testing significantly improved the uptake of HCV antibody testing and linkage to care in at least two studies and the uptake of direct-acting antivirals in a single study, consistent with the effects of point-of-care HIV testing.146–148 Point-of-care testing reduces loss to follow-up by enabling testing to occur onsite, decreases the number of health-care visits needed to receive a diagnosis, and reduces the need for referral to offsite pathologists.149

    • Care of Sexual and Gender Minorities in the Emergency Department: A Scoping Review

      2022, Annals of Emergency Medicine
      Citation Excerpt :

      Thematic analysis by study design is shown in Table 3.24-28,39-46,48-56,59-114,116-192 Subthemes within this category include HIV screening, the treatment of HIV-positive people in the ED, pre-exposure prophylaxis knowledge and uptake in high-risk populations, linkage to care, the opportunity cost with a lack of HIV screening programs, and HIV and sexually transmitted infection education.39-99 These were largely mixed populations that included men who have sex with men and transgender/nonbinary populations.

    • Integrating Pregnancy Prevention Into an HIV Counseling and Testing Program in Pediatric Primary Care

      2018, Journal of Adolescent Health
      Citation Excerpt :

      The ACTS program approach was chosen because it is a well-known testing approach that has been found to increase HIV testing among adolescents [29]. Additionally, the use of rapid HIV testing, as opposed to venipuncture, is more acceptable to adolescents and increases testing rates and results receipt [30]. As part of the program protocol, CHEs approached patients in their examination room who met the program criteria: individuals aged 13–25 who had been identified as being in need of HIV testing based on the Centers for Disease Control and Prevention testing guidelines (i.e., testing all patients 13 years and older once, regardless of their sexual activity, and all sexually active patients at least annually), and completed opt-out rapid HIV screening [5].

    • POC tests in microbial diagnostics: Current status

      2015, Methods in Microbiology
      Citation Excerpt :

      Rapid oral tests for home-based testing of HIV can contribute to increase the coverage of populations at risk and are seen as a way of better controlling epidemics, especially in high-prevalence settings where the test positive predictive value with oral specimens is estimated to 98.7%. In industrialised countries, not only accurate, rapid, and inexpensive POC tests are needed to control the STI epidemics, but rapid POC testing done in outpatient clinics can increase compliance to treatment while impacting the transmission rate within the population, if the result can be obtained while the patient is still in the clinic (Gaydos & Hardick, 2014; Hsieh et al., 2010; Khabbaz et al., 2014; Loubiere & Moatti, 2010; Rompalo et al., 2013; Tucker et al., 2013; Turner et al., 2013; Watchirs Smith et al., 2012). In developing countries, the availability of low-cost POC tests for malaria and HIV has transformed the management of these diseases, but the situation is much more complex in the context of synergistic epidemics of HIV and multidrug and extensively drug-resistant tuberculosis where molecular diagnostics performed at POC would have a great impact on global public health (Chan et al., 2013; Dheda, Ruhwald, Theron, Peter, & Yam, 2013; Ellner, 2009; Günther, 2014; Pai & Pai, 2012; Weyer, Carai, & Nunn, 2011; Young, Perkins, Duncan, & Barry, 2008).

    View all citing articles on Scopus
    View full text