HIV Seropositivity Clinical Trial
Official title:
"Au Labo Sans Ordo ": A 12 Month Local Experimentation of Free HIV Testing Without Prescription in Private Medical and Biological Laboratories in Paris and in the Alpes-Maritimes
The program " Au labo sans ordo " aims to increase HIV testing coverage, in order to improve the first stage of the HIV care cascade in Paris and the Alpes-Maritimes, areas facing a much higher HIV epidemic than the other regions in metropolitan France. Both departments are engaged in the Fast Track Cities Initiative.
The program relies on the hypothesis that the opportunity to get tested for HIV for free
(called VihTest) in any Private Laboratory (PL), without prior appointment nor prescription,
combined with an intense targeted promotion and communication strategy, will significantly
increase the testing coverage. This offer might remove some of the multiple barriers to HIV
testing and ease the move to action, in particular within key affected populations which
contribute to the largest part of the epidemic dynamic.
This program offers a new access to HIV testing. It is developed jointly by local
authorities, the health insurance and state regional health agencies, in response to the very
low increase of HIV testing coverage despite a diversification of the testing supply and
national recommendations for generalized and repeated HIV testing within key populations.
The experimentation will be implemented for 12 months in all Private Laboratories in Paris
(164) and the Alpes-Maritimes (107), targeting a 15% increase in the total volume of tests
performed outside of hospital settings.
The evaluation process will focus on:
Axis 1 : The number of tests performed and the number of new HIV diagnosis considering the
potential substitution effect towards the current testing provision through CeGIDD (free
Centers for Information, Diagnosis and Testing) and community-based outreach testing
programs.
Axis 2 : The linkage to care following an HIV positive test will be organized and documented
and the characteristic of HIV+ population diagnosed after VihTest will be describe
(ALSO_PARCOURS) Axis 3: The characteristics of the program's users will be collected and
compared 1) to those of PL attendants with a medical prescription for an HIV test and 2) to
CeGIDD clients.
Axis 4: The feasibility and acceptability of the program by the PL's staff will be documented
using detailed qualitative questionnaire; Axis 5: The cost-effectiveness of scaling-up such a
testing strategy and its budgetary impact will be assessed through a microcoasting
evalutation.
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