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A systematic review of HIV testing among Canadian populations

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Abstract

OBJECTIVE: Regular HIV testing and early detection leads to timely treatment. Appropriate treatment and care can prevent disease progression in the individual and prevent onwards transmission within the community. This review describes HIV testing coverage in populations disproportionately affected by HIV and in the general population in Canada.

METHODS: A search of published and grey literature on HIV testing uptake in Canada was conducted. Studies reporting quantitative data on testing practices (ever tested, recent testing, and regular testing), published in either English or French from 2008–2012, were included. Studies that involved testing for immigration or prenatal purposes, and post-intervention studies, were excluded. Included studies were assessed using a modified version of the Public Health Agency of Canada’s Descriptive Study Critical Appraisal Tool. Pooled prevalence for percent ever tested was calculated for subpopulations and heterogeneity was estimated using the l2 statistic.

SYNTHESIS: A total of 26 studies were included in the review. The highest rates of ever having been tested were among people who inject drugs (90.6%) and inmates (90.4%); followed by men who have sex with men (83.0%); Aboriginal peoples (55.5%); and the general population (32.8%). Limited information was available on regular and recent testing.

CONCLUSION: HIV testing can reduce the number of undiagnosed cases in Canada. Future research should focus on testing coverage in certain populations, and on the extent to which populations engage in regular testing.

Résumé

OBJECTIF: Des tests réguliers de dépistage et une détection précoce du VIH entraînent un traitement en temps opportun. Des traitements et des soins appropriés peuvent éviter la progression de la maladie chez un individu et prévenir la retransmission du virus au sein d’une collectivité. Le présent examen décrit la couverture de dépistage du VIH au sein des populations disproportionnellement touchées par le VIH et au sein de la population générale du Canada.

MÉTHODES: Une recherche a été menée à l’échelle de la littérature grise et des documents publiés sur la prise de tests de dépistage du VIH au Canada. Des études signalant des données quantitatives sur des pratiques de dépistage (sujets ayant déjà passé un test, sujets testés récemment et sujets procédant à des tests réguliers), publiées en anglais ou en français de 2008 à 2012, ont été incluses dans la recherche. Les études portant sur le dépistage prénatal ou auprès des immigrants et les études menées après les interventions, elles, ont été exclues. Les études incluses ont été évaluées à l’aide d’une version modifiée de l’outil d’évaluation critique pour les études descriptives de l’Agence de la santé publique du Canada. La prévalence groupée pour le pourcentage de gens ayant déjà passé un test de dépistage a été calculée pour les sous-populations, et l’hétérogénéité a été estimée à l’aide de la statistique l2.

SYNTHÈSE: Au total, 26 études ont été incluses dans l’examen. Les utilisateurs de drogues injectables (90,6 %) et les détenus (90,4 %) avaient les taux les plus élevés de tests de dépistage. Ces groupes étaient suivis des hommes ayant des relations sexuelles avec d’autres hommes (83 %), des Autochtones (55,5 %) et de la population générale (32,8 %). Les renseignements accessibles sur les tests réguliers et les tests récents étaient limités.

CONCLUSION: Les tests de dépistage du VIH peuvent réduire le nombre de cas non diagnostiqués au Canada. Les prochaines recherches devraient insister sur la couverture du dépistage au sein de certaines populations et sur la mesure dans laquelle les populations procèdent à des tests réguliers.

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Authors and Affiliations

  1. Centre for Communicable Diseases and Infection Control (CCDIC), Public Health Agency of Canada, 100 Eglantine Driveway, Ottawa, ON, K1A 0R5, Canada

    Shalane Ha BASc, Dana Paquette PhD, Jill Tarasuk MSc, Jeff Dodds, Margaret Gale-Rowe MD, MPH, James I. Brooks MD, John Kim MPH, PhD & Tom Wong MD, MPH

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  1. Shalane Ha BASc
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  2. Dana Paquette PhD
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  3. Jill Tarasuk MSc
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  4. Jeff Dodds
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Correspondence to Shalane Ha BASc.

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Ha, S., Paquette, D., Tarasuk, J. et al. A systematic review of HIV testing among Canadian populations. Can J Public Health 105, e53–e62 (2014). https://doi.org/10.17269/cjph.105.4128

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