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Can a smart application stimulate the HIV test in Canada?



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HIV self-evaluation strategies have been recommended by the World Health Organization (WHO) since 2016, as they enable people to discover HIV their condition at their convenience. Home-based test kits have not yet been approved for sale in Canada. However, a team from the McGill University Health Research Institute (RI-MUHC) and Clinique Médicale collaborators at Actuel, in Montreal, evaluated a self-test program not monitored by HIV through an application for smartphones and a tablet called HIVSmart !, between a population at risk (men who have sex with men). The findings of his study, Canada first, have been published online this week at Internet Medical Research Magazine.

"To achieve the first 95 of the so-called 95-95-95 targets established by UNAIDS * by 2030, it is imperative that we help detect HIV in those who do not know their HIV status. A detection strategy that has the potential of" # 39; reaching the undiagnosed is the autostest of HIV, "says Dr. Nitika Pant Pai, lead author of this study and researcher for Infectious Diseases and Immunity in the World Health Program of RI-MUHC, and Associate Professor of Medicine at McGill University. "HIVSmart! Links all the loopholes in the self-checking process; it works with any homologated HIV self-test, it facilitates testing and informs proactively the user."

"By promoting the projection, HIVSmart! Could help reduce the number of people living with HIV who do not know their status and allow them to start treatment before," adds Dr. Réjean Thomas, co-author of studies, who is also the founder and general manager of Clinique Médicale L & # 39; Actuel. & # 39; & # 39; An application like HIVSmart! Increase accessibility to testing, especially outside large cities, where it is sometimes more difficult to prove for confidentiality issues. "

HIVSmart! It is available for confidential IT applications for smartphones, tablets, or the web (Android, iPhone and iPad) that was developed by Dr. Pant Pai and his team at RI-MUHC. It reports, interprets and stores data confidentially but, most importantly, it links users to counseling or care quickly and encourages the user to keep in mind. Initially developed with funds from Grand Challenges Canada, HIVSmart! It was evaluated in Montreal thanks to this study funded by the Canadian Health Research Institutes (CIHR).

HIVSmart! viability in Montreal

Between July 2016 and February 2017, the researchers conducted a study on 451 men who had sex with men (sometimes called MSM) between 18 and 73 years who presented themselves at Clinique Médicale L & # 39; Actuel to test HIV. An HIV-based home-based saliva test and a tablet equipped with HIVSmart were offered! Application The strategy simulated the tests in an unsupervised domestic environment. Using HIVSmart !, the participants were guided through the autotest process, learning to perform and interpret the test, to store the results and receive attention quickly.

"Our study shows that HIVSmart! The strategy of implementation is feasible, accepted and preferred by a educated and urban population of MSM in Montreal," says Dr. Pant Pai "As a strategy, it adapts to people who prefer to try their comfort in the comfort of a private space such as their home, office or kiosks. This is empowered!"

Autodiagnosis of HIV for populations at risk

In Canada, the HIV epidemic is disproportionately represented in key populations, such as MSM, injecting drug users, indigenous populations and immigrants from endemic HIV countries. About 18 to 25 percent of Canadian MHS populations do not know their positive HIV status, and the number may be proportionally higher for IDUs, indigenous peoples and immigrants, underscoring the need Autocad services accessible to HIV.

"Currently, we have all the means to eradicate HIV. The HIVSmart! Application is a way to support the patient's autonomy," says Dr. Thomas. "The promotion of screening reduces the number of people who do not know their HIV status, places people with HIV with a fast treatment so that their viral load can not be detected and, ultimately, eradicate HIV."

The researchers plan to adapt the VIHSmart! Self-diagnosis strategy for many risk populations in Canada and around the world, maximizing the impact on public health. HIVSmart! The strategy is also testing in South Africa.

* A rapid strategy of UNAIDS to end AIDS before 2030:

In 2030, 95% of all people living with HIV will know their HIV status.

In 2030, 95% of all people with an HIV infection diagnosis will receive sustained antiretroviral therapy.

In 2030, 95% of all people who receive antiretroviral therapy will have viral suppression.

KEY TROUBLES

Profile of the participants

  • 84.7% They were educated beyond the high school;
  • 79.5% they were employed;
  • 52.5% It had been tested in the last 6 months.

Main results

  • 99.3% of the participants who were made independently negative and received counseling after their test;
  • 0.7% of the participants who were tested positively and were positively confirmed by the laboratory were related to a doctor on the same day;
  • 98.8% of the participants found that the application was useful;
  • 94% of the participants were willing to recommend it to a friend or partner.

About the study

Screen Pai N, Smallwood M, Desjardins L, Goyette A, Birkas KG, Vassal AF, Joseph L, Thomas R

A program of self-assessment optimized for non-supervised intelligible applications in Montreal, Canada: Cross-sectional study

J Med Internet Res 2018; 20 (11): e10258

DOI: 10.2196 / 10258

PMID: 30465709

This work has been funded by the Canadian Health Research Institutes (CIHR) and Québec-Santé Recherche Fonds (FRQS).

Contact the media:

Julie Robert
McGill University Health Center
514-971-4747
julie [dot] Robert [at] muhc [dot] mcgill [dot] ca

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