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Can Offering Incentives to Test Increase HIV and STI Testing Rates?

Spring 2016

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What Are the Implications of the Review for HIV and STI Testing in Canada?

This systematic review found that incentives may increase the uptake of initial STI testing, especially in non-clinical settings. The results offer us another potential tool with which to address HIV and STI testing rates in Canada. For service providers interested in exploring what role an incentivized testing program could play in their organization some things to consider include:

  • Assessing whether such an approach could help increase uptake of testing in the populations they serve.
  • Considering potential ethical issues around incentivizing certain populations to increase HIV and STI testing.
  • Organizations that don't offer testing can still play a role in the planning and promotion of an incentivized testing strategy through partnerships with other organizations.

However, it's important to remember that:

  • Although four of the seven studies in the review took place in the United States, more Canadian research is needed to help us further understand how effective HIV and STI testing incentives would be in Canada.
  • With the exception of one study, the interventions did not look at whether incentives of different sizes would have different effects on testing rates. The studies also did not explore whether there was a difference between using monetary or non-monetary incentives. More research is needed to help us understand what the optimal type of incentive would be to achieve the greatest increase in HIV and STI testing.
  • The interventions involved different populations, but they did not evaluate the impact of incentives on different populations. Additional research could help us determine whether incentives work the same across all populations, or whether there are some groups of people who would benefit more from this test promotion strategy than others.
  • The authors noted several limitations to the systematic review. Not all studies included in the review were able to ensure that the comparison and intervention conditions were comparable. This means that differences found in the test uptake rates may have been due to another factor that differed between the two conditions. The authors also noted that increases in the availability of HIV treatment over time may have decreased some of the barriers to testing. Finally, there was no economic data on the financial background of the study participants. One limitation of the study not noted by the authors is the issue of publication bias. This may be an issue as there is a tendency among researchers to publish positive results more often than negative results. This can result in drawing the wrong conclusions because not all the studies completed are available for the review.


What Is a Systematic Review?

Systematic reviews are important tools for informing evidence-based programming. A systematic review is a critical summary of the available evidence on a specific topic. It uses a rigorous process to identify all the studies related to a specific research question. Relevant studies can then be assessed for quality and their results summarized to identify and present key findings and limitations. If studies within a systematic review contain numerical data, this data can be combined in strategic ways to calculate pooled estimates. Combining data to produce pooled estimates can provide a better overall picture of the topic being studied.


Resources

Anonymous HIV Testing Program -- Options Clinic, London InterCommunity Health Centre
London, Ontario

Peer HIV Testing -- PHS Community Services Society, Vancouver, British Columbia

Erica Lee is the Information Specialist at CATIE. Since earning her Master of Information Studies, Erica has worked in the health library field, supporting the information needs of frontline service providers and service users. Before joining CATIE, Erica worked as the Librarian at the AIDS Committee of Toronto (ACT).


References

  1. Wei C, Herrick A, Raymond HF, Anglemyer A, Gerbase A, Noar SM. Social marketing interventions to increase HIV/STI testing uptake among men who have sex with men and male-to-female transgender women. Cochrane Database of Systematic Reviews. 2011;(9).
  2. Thornton AC, Delpech V, Kall MM, Nardone A. HIV testing in community settings in resource-rich countries: a systematic review of the evidence. HIV Medicine. 2012 Aug;13(7):416-26.
  3. Pottie K, Medu O, Welch V, Dahal GP, Tyndall M, Rader T, et al. Effect of rapid HIV testing on HIV incidence and services in populations at high risk for HIV exposure: an equity-focused systematic review. BMJ Open. 2014;4(12):Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4267075.
  4. Pettifor A, MacPhail C, Nguyen N, Rosenberg M. Can money prevent the spread of HIV? A review of cash payments for HIV prevention. AIDS and Behavior. 2012 Oct; 16(7): 1729-1738. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3608680/.
  5. Malotte CK, Hollingshead JR, Rhodes F. Monetary versus nonmonetary incentives for TB skin test reading among drug users. American Journal of Preventive Medicine. 1999; 16(3): 182-188.
  6. Lee R, Cui RR, Muessig KE, Thirumurthy H, Tucker JD. Incentivizing HIV/STI testing: a systematic review of the literature. AIDS and Behavior. 2014 May;18(5):905-12.
  7. Public Health Agency of Canada. Summary: Estimates of HIV Prevalence and Incidence in Canada, 2014. Surveillance and Epidemiology Division, Professional Guidelines and Public Health Practice Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, 2015. Available at: www.catie.ca/en/resources/summary-estimates-hiv-incidence-prevalence-and-proportion-undiagnosed-canada-2014.
  8. Samji H, Cescon A, Hogg RS, et al. Closing the Gap: Increases in life expectancy among treated HIV-positive individuals in the United States and Canada. PLoS One. 2013 Dec 18;8(12):e81355.
  9. The INSIGHT START Study Group. Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection. New England Journal of Medicine. 2015 Aug 27;373(9):795-807. Available at: http://www.nejm.org/doi/full/10.1056/NEJMoa1506816.
  10. Althoff KN, Gange SJ, Klein MB, et al. Late Presentation for Human Immunodeficiency Virus Care in the United States and Canada. Clinical Infectious Diseases. 2010 Jun;50(11):1512-20.
  11. Hall HI, Halverson J, Wilson DP, et al. Late diagnosis and entry to care after diagnosis of human immunodeficiency virus infection: a country comparison. PloS One. 2013;8(11):e77763.
  12. Miller WC, Rosenberg NE, Rutstein SE, Powers KA. Role of acute and early HIV infection in the sexual transmission of HIV. Current Opinion in HIV and AIDS. 2010 Jul;5(4):277-82.
  13. Brenner BG, Roger M, Routy J et al. High rates of forward transmission events after acute/early HIV-1 infection. Journal of Infectious Diseases. 2007 Apr 1;195(7):951-9.
  14. Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. Journal of Acquired Immune Deficiency Syndromes. 2005 Aug 1;39(4):446-53.
  15. Rodger A, Bruun T, Valentina C, et al. HIV Transmission risk through condomless sex if HIV+ partner on suppressive ART: PARTNER Study. In: Program and abstracts of the 21st Conference on Retroviruses and Opportunistic Infections, 3-6 March 2014. Abstract 153LB.
  16. Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. New England Journal of Medicine. 2011 Aug 11;365(6):493-505.
  17. Public Health Agency of Canada. Report on Sexually Transmitted Infections in Canada: 2012. Centre for Communicable Diseases and Infection Control, Infectious Disease Prevention and Control Branch, Public Health Agency of Canada; 2015. Available at: www.catie.ca/sites/default/files/Report-on-STIs-in-Canada-2012.pdf
  18. Government of Canada Statistics Canada. Prevalence of Chlamydia trachomatis and herpes simplex virus type 2: Results from the 2009 to 2011 Canadian Health Measures Survey. Statistics Canada Health Reports. 2013;24(4). Available at: www.statcan.gc.ca/pub/82-003-x/2013004/article/11777-eng.htm. [accessed May 27, 2015]
  19. Bradshaw D, Matthews G, Danta M. Sexually transmitted hepatitis C infection: the new epidemic in MSM? Current Opinion in Infectious Diseases. 2013;26(1):66-72.
  20. Burchell AN, Gardner SL, Mazzulli T, et al. Hepatitis C virus seroconversion among HIV-positive men who have sex with men with no history of injection drug use: Results from a clinical HIV cohort. Canadian Journal of Infectious Diseases & Medical Microbiology. 2015;26(1):17-22.
  21. Trussler T, Banks P, Marchand R, Robert W. ManCount Sizes-up the Gaps: A Sexual Health Survey of Gay Men in Vancouver. Vancouver: Vancouver Costal Health; 2010.
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This article was provided by Canadian AIDS Treatment Information Exchange. It is a part of the publication Prevention in Focus: Spotlight on Programming and Research. Visit CATIE's Web site to find out more about their activities, publications and services.
 

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