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Can a smart app promote HIV testing in Canada?



The World Health Organization (WHO) has recommended HIV self-testing strategies starting in 2016 as they allow people to find their condition for their convenience. Home testing kits are not yet approved for sale in Canada. However, the McGill University Health Center Research Institute (RI-MUHC) and Clinique Médicale l'Actuel, the Montreal colleagues team evaluated an uncontrolled HIV self-testing program using a smartphone and tablet application named HIVSmart! people at risk (men who have sex with men). The results of this research, the first Canada, were published online this week Medical internet research journal.

"In order to achieve the first 95 of the 95-95-95 goals set by UNAIDS * by 2030, we definitely need to help identify HIV among people who are not aware of their HIV status. A screening strategy that has the potential for inadequate diagnosis is HIV testing," says Dr. Pant Pai, research director and researcher at RI-MUHC World Health Program for Infectious Diseases and Immunity Research and McGill University Associate Professor of Medicine. "HIVSmart! Incorporates all the gaps in the self-testing process, it works with any validated HIV testing, facilitates testing and actively informs the user."

"By promoting screening, HIVSmart! Could help reduce the number of people living with HIV who are unaware of their status and allow them to begin treatment earlier," adds the co-author of the study Dr. Réjean Thomas, who is also the founder and CEO of Clinique Médicale L & # 39; Actuel. & # 39; & # 39; Application such as HIVSmart! increases the availability of testing, especially outside large cities, which is sometimes more difficult to test due to confidentiality issues. "

HIVSmart! Available to your smartphone, tablet, or web (Android, iPhone, and iPad), a confidential software application developed by Dr. Pant Pai and her team RI-MUHC. It informs, interprets and stores data confidentially, but, above all, quickly connects those users with counseling or care and encourages users to stay in care. Initially developed with funding from Grand Challenges Canada, HIVSmart! was evaluated in Montreal, thanks to this study, funded by the Canadian Health Research Institute (CIHR).

HIVSmart! probability in Montreal

Between July 2016 and February 2017, researchers conducted a study on 451 male males (sometimes referred to as MSMs) aged 18-73 years who presented the HIV test in Clinique Médicale L & # 39; Actuel in a clinical study. They were offered an internal saliva-based HIV test and a HIV-equipped tablet! The Strategy strategy mimicked testing in an uncontrolled home environment. Using HIVSmart! Participants were guided in the process of self-examination, learned to perform and interpret the test, keep the results and receive care quickly.

"Our study shows that HIVSmart! A training strategy is possible, accepted and favored by educated, JMM residents in Montreal," says Dr. Pant Pai. "As a strategy, it is suitable for individuals who prefer to test themselves in a comfortable private space, such as their home, office or kiosks, which makes it possible!"

HIV self-sustainability in risk groups

In Canada, the HIV epidemic is disproportionately represented in key populations such as WMD, IDUs, indigenous people and immigrants from HIV-endemic countries. About 18-25 percent of the Canadian MII population is unaware of their HIV status and may be proportionally higher among IDUs, indigenous peoples and immigrants, which underlines the need for affordable HIV post-office services.

"At the moment, we have all the means to eradicate HIV. HIVSmart! The app is a way to support patients' autonomy," says Dr. Thomas. "Promoting screening reduces the number of people who are not aware of their HIV status, promptly expose HIV positive people so that their viral fees become undetectable and ultimately eliminate HIV."

Researchers plan to adapt HIVSmart! self-testing strategy for many risk groups in Canada and worldwide, thereby maximizing the impact on public health. HIVSmart! The strategy is also being tested in South Africa.

* A UNAIDS rapid strategy to put an end to AIDS by 2030:

By 2030, 95% of all people living with HIV are aware of HIV status.

By 2030 95% of people with HIV infection will receive long-term antiretroviral therapy.

By 2030, 95% of patients receiving antiretroviral therapy will stop the virus.

KEY CONCLUSIONS

Participants profile

  • 84.7% was taken out of high school;
  • 79.5% were employed;
  • 52.5% was tested in the last 6 months.

Main results

  • 99.3% of the participants who tested themselves negatively and received a post-test consultation;
  • 0.7% of the participants who self-checked the positive response and were positively approved by the laboratory, were connected with the doctor on the same day;
  • 98.8% of the participants acknowledged that the app is useful;
  • 94% of the participants were ready to recommend to their friend or partner.

About the study

Article Pai N, Smallwood M, Desjardin L, Goyette A, Tags KG, Vassal AF, Joseph L, Thomas R

Continuous Smart App-Optimized HIV Self-Examination Program in Montreal, Canada: cross-sectoral study

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

DOI: 10.2196 / 10258

PMID: 30465709

This work was funded by the Canadian Health Research Institute (CIHR) and the Fond de Recherche du Québec-Santé (FRQS).

Contact person:

Julia Roberta
McGill University Health Center
514-971-4747
julie [dot] roberts [at] muhc [dot] mcgill [dot] ca


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