The objective of the OptTEST project is to develop and implement context-sensitive HIV testing programmes in various European countries. ‘Context-sensitive’ refers to the need to consider contextual factors when designing health care programmes that address HIV infection. Contextual factors include organisational issues, stigmatization and procedural dynamics. The project is concerned with both first-time testing and regular surveillance programmes. Countries to be explored and which shall act as pilots include the UK, France, Spain, Poland, Greece, Portugal and Estonia.
Dorthe Raben, Manager of Cohort Coordination and Academic Services
CHIP Department of Infectious Diseases and Rheumatology Section 8632, Finsencentret, Blegdamsvej 9
Rigshospitalet, University of Copenhagen, CHIP Department of Infectious Diseases and Rheumatology Section 8632 (RegionH, Copenhagen, Denmark)
AIDS Fonds (Amsterdam, Netherlands); European AIDS Treatment Group (EATG, Brussels, Belgium); Public Health England (PHE, London, England); St Stephen’s AIDS Trust (SSAT, London, England); MEDFASH (London, England); Institut National de la Santé et de la Recherche Médicale (INSERM, Paris, France); Stitching Global Network of People Living with HIV/AIDS (GNP+, Amsterdam, Netherlands); Instituto de Salud Carlos III (ISCIII, Madrid, Spain); National Institute for Health Development (NIHD, Tallinn, Estonia)
The project aims to develop tools for implementing HIV testing programmes that are context-sensitive, taking into account the various factors that impact on programme success. The project builds on the results of previous initiatives in the area such as ‘HIV in Europe’ and ‘Stigma Index’. Recent studies from the United States suggest there is a link between how testing is organised, on the one hand, that is to say in communities or by general practitioners, and the quality of care and treatment, on the other hand. This applies especially to first-time testing. Methodologically, the project follows the ‘indicator condition’ (IC) approach. The project guidelines will be tailored to different countries and settings. Tools to introduce and expand the novel IC-guided HIV testing strategy will be piloted and refined in selected healthcare settings around Europe. Results will lead to the development, and subsequent evaluation and dissemination, of regional/country ‘best practice’ protocols. Finally, the project will use a model-based approach to forecast the long-term cost-effectiveness of different testing strategies.
The expected outcomes of the project include: increased awareness about the benefits of early testing and optimal treatment; better understanding of how context and setting influence treatment and effectiveness; adoption of the ‘Stigma Index’ approach to measure and monitor discrimination against persons with HIV and for implementing institutional and organisational changes to ameliorate conditions for people living with HIV; mainstreaming of the ‘Indicator Condition guided HIV testing’ approach in various national HIV testing programmes. The project’s main target groups are health care professionals, HIV clinicians, and health care managers. Other relevant stakeholders include social workers, civil society organisations and public health officials. Tools and manuals developed by the project will be disseminated in various European languages, notably English, French, Spanish, Estonian and Portuguese.
Duration of Project:
36 Months: June 2014 - May 2017
The project will draw on existing initiatives and concepts, such as the ‘Stigma Index’ and the ‘Indicator Condition guided HIV testing’ approach. These will be applied to various medical and community settings in Europe. The research team will use situational analyses and institutional assessments for establishing the characteristics of various national testing settings and the barriers to access and effective treatment. Small scale cost-effectiveness studies will be carried out in various countries to help establish the relationships between financial viability and effective treatment. Special attention will be given to performance in different settings, such as testing in clinics, testing organised by general practitioners, community-based testing programmes using rapid tests, and home-testing. Expert interviews and facilitated stakeholder dialogues will be used for collecting information, as well as for developing and piloting specific testing strategies. Confirmed pilot countries are UK, France, Estonia, Poland, Greece and Spain.