HIV self-testing strategies have been recommended by the World Health Organization (WHO) since 2016, as they empower people to find HIV their status easily. Home testing packages have not yet been approved for sale in Canada. However, a team from the McGill University Health Center Research Institute (RI-MUHC) and colleagues from Clinique Médicale l & # 39; Actuel, in Montreal, evaluated an unsupervised HIV self-test program via smartphone and tablet telephone application. , the name of HIVSmart!, among the people at risk (men with sex with men). The findings of their study – Canada-first – have been published online this week in Aberystwyth Journal of Medical Internet Research.
"In order to reach the first 95 of 95-95-95 targets called by UNAIDS * by 2030, it is essential that we help to detect HIV in those who are" Living unconsciously of their HIV status. HIV self-testing is a screening strategy that has the potential to reach the diagnosis that is not diagnosed, "said Dr. Nitika Pant Pai, lead author of this study and researcher of the Infectious Disease and Immune In-Health Program of the RI-MUHC, and a Medicine associate professor at McGill University. "HIVSmart! Binds all gaps in the self-testing process; it works with any approved HIV self test, facilitates testing and informing the user proactively."
"By promoting screening, HIVSmart could help reduce the number of people living with HIV who do not know their status and allow them to start treatment earlier," Dr. Réjean Thomas, studying co-author, also founder and Chief Executive Officer Clinique Médicale L & # 39; Actuel. & # 39; & # 39; Request as HIVSmart! increase accessibility to experience, especially outside large cities, where it is sometimes harder to experience due to confidentiality issues. "
HIVSmart! available for confidential software for smart phones, tablets or web (Android, iPhone, and iPad) developed by Dr. Pant Pai and a team at the RI-MUHC. It informs, interprets and stores data confidentially but, most importantly, it connects users to advise or care quickly and encourages the user to remain in care. Having initially started with funding from the Grand Challenges of Canada, HIVSmart! It was evaluated in Montreal thanks to this study funded by Canadian Health Research Institutions (CIHR).
HIVSmart! Feasibility in Montreal
Between July 2016 and February 2017, researchers conducted a study of 451 men with sex (sometimes referred to as MSM) between the ages of 18 and 73 who presented themselves in the Clinic Médicale L & # 39; Actuel to be tested for HIV . I've been offered to have a home saliva HIV Test and have a HIVSmart tablet! App. The test strategy mimicated in a homeless environment unsupervised. Using HIVSmart!, Participants were led through the self-testing process, learning how to perform and interpret the test, results, and store quickly and quickly.
"Our study shows that HIVSmart! An application strategy is practical, accepted and favored by an educative, urban MSM population in Montreal," said Dr. Pant Pai. "As a strategy, it is suitable for individuals who are better to prove at their convenience at the comfort of private space such as their home, office or kiosks. That's empowering!"
Self-testing HIV for populations at risk
In Canada, the HIV epidemic is represented disproportionately in key populations, such as MSM, injection drug users, indigenous populations and immigrants from HIV endemic countries. About 18 to 25 percent of MSM's Canadian populations are not aware of their HIV-positive status, and the number may be higher proportions for IDUs, indigenous populations and immigrants, which underline & The need for accessible HIV self-testing services.
"At the moment, we have every way to eliminate HIV. The HIVSmart! The App is a way of supporting the autonomy of patients," said Dr Thomas. "The promotion of screening reduces the number of people who do not know their HIV status, giving HIV-positive people on treatment quickly so their verbal remuneration becomes unstable, and ultimately eliminates HIV."
Researchers are planning to adapt the HIVSmart! Self-testing strategy for many populations that are at risk in Canada and worldwide, thereby maximizing the impact on public health. HIVSmart! a strategy is also being tested in South Africa.
* UNAIDS Rapid Track Strategy to Spind 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 infection will receive persistent antiiretroviral therapy.
By 2030, 95% of all people with antiretroviral therapy will have viral restraint.
Profile of Participants
- 84.7% educated beyond a secondary school;
- 79.5% employ them;
- 52.5% has been proven in the past 6 months.
- 99.3% of participants who were proven negatively and having counseling after testing;
- 0.7% of participants who were a positive and positive self-tested laboratory who had contacted a doctor within the same day;
- 98.8% of participants see that the app is useful;
- 94% of participants ready to recommend 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
HIV Self-Testing Program Optimized Smart App Optimized in Montreal, Canada: Cross Departmental Study
J Med Internet Res 2018; 20 (11): e10258
DOI: 10.2196 / 10258
This work was funded by the Canadian Health Research Institutions (CIHR) and the Fonds de recherche du Québec – Santé (FRQS).
McGill University Health Center
Julius [dot] robert [at] muhc [dot] mcgill [dot] ca