It is estimated that 14% of Canadians living with HIV (or approximately 9,000 people) do not know that they are HIV-positive. According to the CATIE report (2019), 71% of key players working in testing think that HIV self-testing is an important approach to reach the undiagnosed. Now is an important and critical time here in Canada, as new self-testing technologies are expected to improve testing outreach and provide accurate diagnostic information.
REACH Nexus (part of the CIHR Centre for REACH in HIV/AIDS), led by Dr. Sean B. Rourke at the MAP Centre for Urban Health Solutions at St. Michael’s Hospital, is leading the efforts to bring these new STBBI testing options to market in Canada so that they are available and accessible for those who need them the most. PAN is part of the REACH Nexus team, and we are excited to be support this exciting and important work.
To that end, given a growing number and the anticipated future availability of new testing technologies, now is a good time to provide an overview of some of them and highlight the potential roles that PAN members and allied community-based organizations (CBOs) may play within this changing testing landscape.
Types of self- tests
- INSTI HIV Self-Tests: The first HIV self-test in Canada is awaiting final Health Canada approval to support community-based testing. Approval from Health Canada is expected as soon as August. Once this has been approved, REACH Nexus will be working to distribute these HIV self-tests through a number of different means including an online platform, through implementation studies (like those led by the Community-based Research Centre (CBRC)), and through partnering with CBOs;
- Oral swab HIV and hepatitis C tests: Tests that use saliva are being explored – research to explore the efficacy is being conducted with the earliest start date in mid-2021. These would have potential applications to self-testing;
- Multiplex testing: These are point-of-care medical devices that can test for more than one infection from a single sample (e.g., testing for both HIV and syphilis at once). These devices are currently being tested in Canada and if they perform well they will need to be approved by Health Canada before widespread use;
- Point-of-care hepatitis C testing: This is also being explored.
You can learn more about these new types of self-testing technologies from our CBRC Webinar on New Testing Tech, the CBRC’s New Ways to Get Tested for HIV, Hep C and Syphilis summary document (PAN’s accompanying cover letter document shared with its members and allies along with the CBRC summary), and the CATIE blog on how HIV self-testing can help us end the HIV epidemic. Thanks to CBRC, and to CATIE, for their great work on this to date!
Potential roles for community-based organizations in supporting new testing technologies
To ensure we can support PAN members and CBO’s with these new testing technologies, we want to first outline some aspects of testing that CBOs might be interested in getting involved:
- Conducting point-of-care tests;
- Promoting awareness of HIV self-testing and encouraging frequent and regular use by those who may be infected with HIV;
- Distributing HIV self-tests;
- Being an HIV testing information source for people in your community (including people who have not accessed your services previously). For example, this might include supporting a client who received a self-test from somewhere else; explaining the need for a confirmatory HIV tests for diagnosis if a self-test is reactive; demonstrating how tests are used to those who need help; providing pre- and post-test counselling; and potentially supervising self-tests;
- Assisting with navigation of the appropriate services/resources and follow-up;
- Supporting people who have a negative test in your service delivery region and linking them with prevention (i.e. harm reduction, PrEP, etc.) and ongoing testing supports;
- Supporting people who have a positive test in your service delivery region and linking them with care and/or access to community-based services through a Peer Navigator and/or health care providers.
PAN is currently in the process of reaching out to its members and allied stakeholders to discuss testing needs outside the formal health authority or clinical structures where it has traditionally been done. The results of this needs assessment now underway, will provide information about the roles CBOs may play in supporting self-testing, any potential challenges or opportunities they foresee, and any resources or tools that would support engagement in testing and linkage to care. PAN will use this information to help support our members with testing and self-testing initiatives.
Working with REACH and other partners, the PAN team is committed to supporting greater access to the new testing technologies, and to supporting network members and allied CBOs in getting involved. Thank you for your interest, feel free to get in touch, and certainly more to come!
For more information, we encourage you to register for the REACH Webinar Series: What You Need to Know About HIV Self-Testing in Canada, with the option to attend August 5, 11, or 13, 10 – 11:30 Pacific time.
Questions? Feedback? Get in touch! Leanne Zubowski, REACH Evaluation Coordinator, [email protected]