P5-17. Targeting HIV testing service yields early HIV diagnosis among men having sex with men (MSM)

Pia Kivelä [1], Sami Tuunainen [2], Jukka Keronen [2], Henrikki Brummer-Korvenkontio [3], Matti Ristola [1]
Affiliates: [1] Infectious Diseases, Helsinki University Hospital, Helsinki, Finland. [ 2] Hivpoint, Helsinki, Finland. [3] Health Security, National Institute for Health and Welfare, Helsinki, Finland.

Background
HIV has been previously been diagnosed among MSM as late as among heterosexuals in Finland according to the first CD4 count after HIV diagnosis. Hivpoint is a non-governmental organization that provides anonymous HIV testing in Helsinki since 2012. Hivpoint changed its testing strategy by increasing testing frequency from once monthly to once weekly, by introducing brief testing counselling and out-reach testing at saunas, by using social media and other means of targeted information to recruit MSM to its HIV testing services. Infectious disease clinic at Helsinki University Hospital (HUH) is practically the only unit in the area of Helsinki and Uusimaa to provide HIV and antiretroviral treatment.

Methods
Clients of Hivpoint testing services are offered free, anonymous, and rapid HIV tests. Testing includes pre-test councelling of risk behavior, safe sex practices and information of the window period for HIV antibodies. Test is done from finger prick blood and the result is available with in one minute. Negative test result is given immediately and positive one is confirmed from separately drawn venous blood sample. The confirmatory test results can be given after one week. All confirmed positive cases are further referred to HUH for hospital care.
HUH uses InfCare HIV data system (Health Solutions/BCB) as the quality register for its HIV care. Persons who diagnosed for the first time with HIV infection between the years 2012 and 2016 were identified from the database. We compared the first CD4 count between the transmission risk groups and the referring institution. IBM SSPS Statistics were used statistical analysis.

Results
The median CD4 at HIV diagnosis increased statistically significantly (p=0,017) from 2012 to 2016 among the MSM tested at Hivpoint compared to the MSM tested in other services (Table 1). There was also an increase in the number positive HIV test results of MSM at Hivpoint.

Discussion
Targeted and versatile services provides an effective way to recruit MSM to HIV testing. This strategy yielded an earlier HIV diagnosis than other means of HIV testing.