The online HIV test TESTATE joins Hepatitis C screening
- The online platform TESTATE (Testyourself) developed by CEEISCAT, has proved very successful in the promotion of the HIV test with a 94% of positive cases following treatment
- In a pilot study this system of online request for tests will include the test for the Hepatitis C virus for a thousand users of the platform
- The platform allows the centralization of screening strategies in a group vulnerable to infection by this virus to achieve the elimination of the disease as a public health problem in line with WHO objectives
There are 71 million people in the world with chronic infections with the virus hepatitis C (HCV), according to the World Health Organization (WHO). The new antiviral treatments can cure 95% of cases of HCV infection and the WHO has fixed an objective of eliminating the disease as a public health problem by 2030. In Catalonia there are an estimated 30,000 people infected with HCV.
"As curative treatments already exist, managing to eliminate HVC as a public health problem in Catalonia and Spain requires creative strategies to improve the levels of diagnosis and treatment in vulnerable populations, which have the highest level of infections," explains Jordi Casabona, Scientific Director of the CEEISCAT, the research group at the Germans Trias i Pujol Research Institute, which is spearheading the project. "In our context, nearly 25% of people infected with HIV have also been infected at some time with hepatitis C virus," he adds.
The research project currently underway (pilot study) TESTATE C Plus, aims to bring HCV detection to particularly vulnerable groups via the TESTATE Platform (www.testate.org). The platform has been offering the HIV test throughout Spain since November 2018 and has permitted 3,500 people to access the test privately at home and for free. It will now also offer the possibility of asking for the VHC test. The project has the support provided by the first edition of Commit, the competitive international call for grants from Gilead Sciences.
TESTATE is aimed at users of contact webpages and mobile apps for gay and bisexual men and other men who have sex with men (GBHSH) in Catalonia. The TESTATE C Plus study focusses on this group, especially those who use recreational drugs where the incidences of HCV are especially high. 1,000 people are expected to take part in this pilot study to evaluate the effectiveness of the strategy and evaluate its implementation in the rest of the country.
The project will be adding to several initiatives being taken by the Programme for Prevention, Control and Care for HIV, sexually transmitted diseases and hepatitis (PCAVIHV) to eliminate hepatitis C as a public health problem.
Self-collection of samples: fast and at home
Users of TESTATE C Plus can request a kit to collect their own blood sample from the webpage. "A kit arrives at their house with all the instructions necessary to take a sample. It is a simple finger-prick, which is deposited on a card," explains Dr Cristina Agustí, researcher working on the project. The dry blood sample is sent for free by post to the reference laboratory (Microbiology Unit, Germans Trias i Pujol Hospital) and the results can be consulted online. "When a sample gives a positive result in this test, which detects RNA of the hepatitis C virus, we contact the person to find out if they have had the test confirmed by a blood test and if they have been referred to the reference hepatology service to receive treatment," adds Agustí. In the case of HIV, since 2018, 94% of people with a positive test have connected with the healthcare system and have been able to receive treatment.
High acceptability: easy, free and confidential
The use of new technologies for early diagnosis of HIV has been widely accepted amongst participants, who have highlighted the facts that they don't have to travel to a centre and that it is confidential as key elements. 98% of participants who have replied to the feedback questionnaire on the platform say they would recommend it to their friends and acquaintances. Confidentiality, comfort, that it is free and the fact that participants are not asked questions about their motives for taking the test are the main advantages that users of TESTATE highlight. "For us to carry out epidemiological control it is important to be able to use tools such as these that bring us closer to the users and help our screening strategies," considers Casabona.
TESTATE has users from all the provinces of Spain and has a very high uptake in Madrid and Barcelona. In the case of HIV, the test has been brought to areas of low population, where it is more difficult to get access to testing, thanks to the project. 19% of users of the platform are from towns with fewer than 50,000 inhabitants and it is notable that 24% of the participants have never taken an HIV test.
Alliances with the leading contact apps for men who have sex with men
The TESTATE platform collaborates closely with the most popular contact applications for gays, bisexuals and other men who have sex with men in Catalonia and Spain. Thanks to the established alliances with Grindr, Scruff, Bakala, Wapo, MachoBB, Trans4Men and Planet Romeo the platform has been widely publicized allowing access to users who would otherwise be difficult to contact. The platforms see TESTATE as a chance to offer free tests to their users.
TESTATE is a digital platform led by the CEEISCAT, Centre for Epidemiological Studies of Sexually Transmitted Disease and AIDS in Catalonia, which carries out applied research as a research group at the Germans Trias I Pujol Research Institute (IGTP). The pilot project is being carried out thanks to financing from Gilead Sciences and the Ministry of Health of the Government of Catalonia. The Microbiology Unit of the Germans Trias I Pujol Hospital collaborates closely, as do the NGOs Stop AIDS, Positive Gays, the HIV Working Group and the Public health Agency of Barcelona. The TESTATE C Plus Project collaborates closely with the DisfrutaSinC Project (https://disfrutasin-c.org) promoted by collaborating NGOs, which aims to inform users about sexual practices that could lead to infection by the hepatitis C virus.