HIV community-based testing practices in Europe HIV COBATEST

Early diagnosis of HIV infection is essential to decrease mortality, morbidity and transmission rates, allow counselling and assess suitability for treatment.

Although some of the European countries have universal access to health care, most of the vulnerable groups do not have active seeking behaviours for HIV testing or face important barriers to testing within the formal health care system.

The Community-based voluntary counselling and testing (CBVCT) services are commonly recognized as a good model to improve access to most-at-risk populations by promoting its early HIV diagnosis.

These centres are in excellent position to improve all aspects of the HIV testing and counselling-including access, offer, uptake and effectiveness- for those vulnerable and hard to reach.

The general objective of the project is to promote early diagnosis of HIV infection in Europe by improving the implementation and evaluation of community-based testing practices.

The proposed project will complement previous and current reports and actions, focusing on CBVCT practices, obtaining a deep understanding of these programmes and services across countries and standardizing protocols and indicators to improve their implementation and evaluation.

The project will contribute to the creation of a network of CBVCT that will monitor and evaluate HIV testing activity, and that conduct operational research.

Moreover, the project includes a research question to assess acceptability, feasibility and impact of introducing oral rapid test technologies at CBVCT.

To achieve this, first of all, we will assess the characteristics of the implementation of CBVCT programs in European countries by conducting a survey among national focal points in HIV. Secondly, we will agree on CBVCT specific good practice guidelines by qualitative study among users and providers. Thirdly, this information will allow us to propose a core group of indicators for monitoring and evaluation of CBVCT activity. Fourthly, a standardised protocol to monitor HIV testing activities from the established CBVCT network will be defined.

This will also allow comparability of reported activity at international level. Finally, the assessment of the acceptability, feasibility and impact of introducing oral rapid testing technology at CBVCT network will be made. Increasing number of CBVCT sites enrolled in the network and a major geographical coverage is expected in the future, increasing its contribution to the global surveillance of HIV testing.

The results obtained in the project could be used by European stakeholders to improve the implementation of CBVCT, and strengthen capacity in the European countries, improving access to testing, early diagnosis and care for hard-to-reach groups.

To perform the HIV-COBATEST project, a solid partnership has been formed. Half of the partner institutions are public bodies representing the main public health agencies in their countries, and have already established longstanding working relationships with community organizations that offer VCT. The other half are NGOs that have integrated a CBVCT and that work to fight HIV/AIDS and the stigma attached to people living with HIV/AIDS. The COBATEST project covers countries from Southern, Central, Northern and Eastern Europe with the aim to obtain representative information on the implementation of community-based VCT programs and services across European countries.