Abstract
Introduction
HIV testing opportunities in Italy are frequently limited to the hospital setting. Experiences in other countries show that offering HIV testing in other facilities could improve HIV testing uptake.
Methods
An internet-based survey was conducted between March 10 and April 3, 2014.
Results
A total number of 348 questionnaires were collected. Responders were 88% male. Most represented age groups were 25–34 (35%) and 35–44 (25%). Most of the responders identify themselves as homosexual (81%) or bisexual (9%). Half of responders had an HIV test within 2 years (56%) while 18% never tested for HIV. Among all responders, 61% had more than 2 sexual partners in the past year. Reported condom use in the past year was: always 39%, always but once 11%, sometimes 27%, never 14%. Most known places to have an HIV test is the hospital (95%), STI clinic (58%) and chemical analysis laboratory (54%); most used places are hospital (73%), STI clinic (30%), laboratory (22%) while 5 responders reported having had a self-test at home. Preferred places where to have an HIV test is self-testing at home (53%), hospital (36%), pharmacy (32%) and headquarter of an organization (31%). Most known testing method is draw blood from vein (97%), which is also most used (80%) but the least preferred (31%) while saliva (65%) and finger prick (56%) are the preferred choices. Most responders know that physicians (84%) and nurses (77%) are those who perform HIV tests and most of them had an HIV test with them (60% and 65% respectively). Physicians are the preferred operators (54%) followed by self-testing (46%), nurses (46%) and peer-volunteers (39%). The ideal HIV test should be: reliable (86%), with no medical prescription (75%), free (63%), rapid (55%), with no personal information collected (45%), with the opportunity to speak with a peer-counsellor (36%).
Conclusions
Changing HIV testing policies in Italy is urgently needed in order to grant a better access to the service: waiting for the results and bureaucratic obligations represent the major barriers to be removed. Home-testing and community-based testing seem to be among the best ways to offer new opportunities though they may require a change in the legal, social and cultural context to be implemented and home testing will not allow any kind of support for newly diagnosed people.
Table 1.
Survey results
| Which places for HIV testing do you know? | % | N | Which places for HIV testing did you use? | % | N | Which places for HIV testing would you like to use? | % | N | Which procedures for HIV testing do you know? | % | N | Which procedures for HIV testing did you use? | % | N | Which procedures for HIV testing would you like to use? | % | N | Which operator for HIV testing do you know? | % | N | Which operator for HIV testing did you use? | % | N | Which operator for HIV testing would you like to use? | % | N | How would your preferred test be? | % | N |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Hospital | 94.8 | 330 | Hospital | 73.0 | 254 | Hospital | 36.5 | 127 | Vein blood draw | 96.6 | 336 | Vein blood draw | 80.5 | 280 | Vein blood draw | 31.3 | 109 | Physician | 83.9 | 292 | Physician | 60.1 | 209 | Physician | 54.0 | 188 | It's mandatory to be free | 63.2 | 220 |
| STI clinic | 57.8 | 201 | STI clinic | 30.5 | 106 | STI clinic | 27.3 | 95 | Finger prick | 30.5 | 106 | Finger prick | 5.5 | 19 | Finger prick | 55.7 | 194 | Nurse | 76.7 | 267 | Nurse | 64.9 | 226 | Nurse | 45.7 | 159 | I can pay 5–10 € to have it as I want it | 39.4 | 137 |
| Drug abuse service | 23.6 | 82 | Drug abuse service | 2.3 | 8 | Drug abuse service | 4.6 | 16 | Saliva | 43.1 | 150 | Saliva | 10.6 | 37 | Saliva | 65.2 | 227 | Pharmacist | 2.6 | 9 | Pharmacist | 0.3 | 1 | Pharmacist | 20.7 | 72 | Medical prescription must not be necessary | 74.7 | 260 |
| Pharmacy | 2.6 | 9 | Pharmacy | 0.3 | 1 | Pharmacy | 31.9 | 111 | Don't know | 0.6 | 2 | Never tested | 16.7 | 58 | HIV+, will not test | 16.1 | 56 | Lab operator | 39.9 | 139 | Lab operator | 19.3 | 67 | Lab operator | 27.6 | 96 | Result must be available rapidly (20–30 minutes) | 55.7 | 194 |
| Analysis Lab | 53.7 | 187 | Analysis Lab | 21.6 | 75 | Analysis Lab | 20.7 | 72 | Don't know | 0.3 | 1 | Don't know | 0.6 | 2 | Volunteer | 23.9 | 83 | Volunteer | 9.8 | 34 | Volunteer | 38.5 | 134 | It's mandatory to be extremely reliable | 85.9 | 299 | |||
| Street unit | 25.9 | 90 | Street unit | 3.2 | 11 | Street unit | 22.4 | 78 | Myself (home-testing) | 14.4 | 50 | Myself (home-testing) | 2.3 | 8 | Myself (home-testing) | 46.0 | 160 | Name, surname, ID must not be requested | 44.5 | 155 | |||||||||
| Org. Headquarter | 23.6 | 82 | Org. Headquarter | 6.9 | 24 | Org. Headquarter | 31.0 | 108 | Don't know | 1.1 | 4 | Never tested | 16.4 | 57 | HIV+, will not test | 14.9 | 52 | I want a physician to be present | 21.0 | 73 | |||||||||
| Home testing | 8.6 | 30 | Home testing | 1.4 | 5 | Home testing | 52.6 | 183 | Don't know | 0.3 | 1 | Don't know | 1.4 | 5 | Don't want to receive counselling | 29.0 | 101 | ||||||||||||
| Don't know | 0.9 | 3 | Never tested | 16.1 | 56 | HIV+, will not test | 10.6 | 37 | I want to receive peer-counselling | 35.6 | 124 | ||||||||||||||||||
| Don't know | 0.6 | 2 | Don't know | 1.1 | 4 | I want to receive counselling from a physician | 23.9 | 83 | |||||||||||||||||||||
| Other | 0.9 | 3 |