Targeting late diagnosis of HIV in Kent, Medway and Picardy: evaluation of interventions in the Anglo-French IMPRESS Health 2 (Interreg IVA Channel Programme) project 4282

This report outlines the results and final stakeholder evaluations for the intervention phase (phase 3) of the Interreg IVA Channel Programme 4282 IMPRESSHealth 2 study. It describes how recommendations from the phase 1 report were implemented in Kent, Medway and Picardy in Northern France, the impact which these had on the uptake and timeliness of HIV testing in these areas; and analysis of the reasons for variance between the two countries (UK and France). The report contains examples of some of the public health and social media materials developed to increase the uptake and timeliness of HIV testing, and the results of the stakeholder assessment of its success. Overall, the impact of the interventions have been successful, with widespread increases in both the number and timeliness of HIV testing in the UK though less so in France. Reasons for these differences are discussed in the report. The report also highlights the huge contribution which social and broadcasting media can make to public health campaigns of this nature, and the value of multi-sector and inter-organisational team working.

Adler, A., Mounier-Jack, S., Coker, R.J. (2010) Late diagnosis of HIV in Europe: definitional and public
health challenges. Health Sciences, 21(3):284-293.

Albarracin, D. and Durantini, M. (2010) Are we going to close social gaps in HIV? Likely effects of behavioral HIV-prevention interventions on health disparities. Psychology, Health & Medicine, 15(6):694-719.

Almasi Nokiani, F. (2010) HIV infection in elderly patients over 65 years. International Journal of Infectious Diseases, 14(Supp 1):e75

AVERT (Averting HIV and AIDS). HIV & AIDS in Western & Central Europe. Available at:
http://www.avert.org/european-hiv-aids-statistics.htm. Accessed: 8 December 2014.

British HIV Association (BHIVA). Audit of mortality. [Online]. Available at:
http://www.bhiva.org/files/file1001379.ppt#2 accessed: 29th August 2012.

Bonjour, M.A., Montagne, M., Zambrano, M., Molina, G., Lippuner, C., Wadskier, F.G., Castrillo, M., Incani, R.N., Tami, A. (2008) Determinants of late disease-stage presentation at diagnosis of HIV infection in Venezuela: A case-case comparison. AIDS Research Therapy, 5(6).

Branson, B.M., Handsfield, H.H., Lampe, M.A., Janssen, R.S., Taylor, A.W., Lyss, S.B., Clark, J.E. (2006)
Revised recommendations for HIV testing of adults, adolescents and pregnant women in health-care
settings. MMWR Recomm Rep, 55(RR14):1-17.

Camoni, L., Raimondo, M., Regine, V., Salfa, M.C., Suligoi, B. (2013) Late presenters among persons with a new HIV diagnosis in Italy, 2010-2011. BMC Public Health, 13:281.

Carrizosa, C.M., Blumberg, E.J., Hovell, M.F., Martinez-Donate, A.P., Garcia-Gonzalez, G., Lozada, R., Kelley, N.J., Hofstetter, C.R., Sipan, C.L. (2010) Determinants and prevalence of late HIV testing in Tijuana, Mexico. AIDS Patient Care STDS, 24:333-40.

Casau, N.C. (2005) Perspective on HIV infection and aging: Emerging research on the horizon. Clinical
Infectious Diseases, 41:855-863.

Castilla, J., Sobrino, P., De La Fuente, L., Noguer, I., Guerra, L., Parras, F. (2002) Late diagnosis of HIV
infection in the era of highly active antiretroviral therapy: Consequences for AIDS incidence. AIDS,16(14):1945-1951.

Chadborn, T.R., Delpech, V.C., Sabin, C.A., Sinka, K., Evans, B.G. (2006) Late diagnosis and consequent
short term mortality. AIDS, 20(18):2371-9.

Centers for Disease Control (2003) Late versus early testing of HIV – 16 sites, United States. MMWR
Morb Mortal Wkly Report, 52:581-586.

Cu-Uvin, S., Snyder, B., Harwell, J.I., Hogan, J., Chibwesha, C., Hanley, D., Ingersoll, J., Kurpewski, J.,
Mayer, K.H., Caliendo, A.M. (2006) Association between paired plasma and cervicovaginal lavage fluid HIV-1 RNA levels during 30 months. Journal of Acquired Immune Deficiency Syndrome, 42:584-587.

Davis, D. H., Smith, R., Brown, A., Rice, B., Yin, Z., Delpech, V. (2013) Early diagnosis and treatment of
HIV infection: magnitude of benefit on short-term mortality is greatest in older adults. Age and Ageing,
42(4):520-526/58.

Delpierre, C., Cuzin, L., Lert, F. (2007) Routine testing to reduce late HIV diagnosis in France. British
Medical Journal, 334(7608):1354-1356.

DeMarco, R.F., Gallagher, D., Bradley-Springer, L., Jones, S.G. and Visk, J. (2012) Recommendations and reality: Perceived patient, provider, and policy barriers to implementing routine HIV screening and proposed solutions. Nursing Outlook, 60(2):72-80.

Department of Health (2008) HIV post-exposure prophylaxis: Guidance from the UK Chief Medical
Officers’ Expert Advisory Group on AIDS. London: DoH.

Dilernia, D.A., Monaco, D.C., Cesar, C., Krolewiecki, A.J., Friedman, S.R., Cahn, P. and Salomon, H. (2013) Estimation of HIV-testing rates to maximize early diagnosis-derived benefits at the individual and population level. PloS one, 8(1):e53193.

Direction générale de la santé (2009) ‘HIV infection screening in France’, 2009. Haute Autorité de Sante.

Dowson, L., Kober, C., Perry, N., Fisher, M., Richardson, D. (2012) Why some MSM present late for HIV testing: a qualitative analysis. AIDS Care, 24(2):204-209.

EU. Action Plan on HIV/AIDS in the EU and neighbouring countries: 2014-2016. [Online]. Available at:
http://ec.europa.eu/health/sti_prevention/hiv_aids/index_en.htm. Accessed 1 March 2014.

European Centre for Disease Prevention and Control (2012) HIV testing: increasing uptake and effectiveness in the European Union: Evidence synthesis for Guidance on HIV testing. Technical Report, Stockholm: European Centre for Disease Control

European Centre for Disease Prevention and Control (2011) HIV/AIDS surveillance in Europe 2011. Brussels: European Centre for Disease Control and World Health Organisation.

European Centre for Disease Prevention and Control (2010). HIV testing: increasing uptake and effectiveness in the European Union. Stockholm: European Centre for Disease Control.

European Communities (2008) Major and Chronic Diseases Report 2007. Luxembourg: European Commission. ISBN 92-79-08896-4.

Garcia de Olalla, P., Manzardo, C., Sambeat, M.A., Ocana, I., Knobel, H., Humet, V., Domingo, P., Ribera,
E., Guelar, A., Marco, A., Belza, M.J., Miro, J.M., Cayla, J.A. (2011) Epidemiological characteristics and
predictors of late presentation of HIV infection in Barcelona (Spain) during the period 2001-2009. AIDS Research and Therapy, 8(22).

Girardi, E., Sabin, C., d’Arminio Monforte, A. (2007) Late diagnosis of HIV infection: Epidemiological
features, consequences and strategies to encourage earlier testing. Journal of Acquired Immune
Deficiency Syndrome, 46(Supp 1):3-8.

Hanf, M., Bousser, V., Parriault, M.C., Van-melle, A., Nouvellet, M., Adriouch, L., Sebillotte, C.G.,
Couppie, P., Nacher, M. (2011) Knowledge of free voluntary HIV testing centres and willingness to do a
test among migrants in Cayenne, French Guiana. AIDS Care, 23(4):476-485.

Health Protection Agency (2011) HIV in the United Kingdom: 2011 Report. London; Health Protection
Services, Colindale. 59

Health Protection Agency (2011) United Kingdom New HIV Diagnoses to end of June 2011. London, Health Protection Agency.

Hooshyar, D., Hanson, D.L., Wolfe, M., Selik, R.M., Buskin, S.E., McNaghten, A.D. (2007) Trends in
perimortal conditions and mortality rates among HIV-infected patients. AIDS, 21:2093- 2100.

Ilaria, G., Jacobs, J.L., Polsky, B., Koll, B., Baron, P, MacLow, C., Armstrong, D. Schlegel, P.N. (1992)
Detection of HIV-1 DNA sequences in pre-ejaculatory fluid. Lancet, 340: 1469.

Institute of Health Surveillance/L’Institut de veille sanitaire. HIV/AIDS Statistics for 2012. [Online].
Available at: http://www.aides.org/actu/france-6-372-personnes-ont-decouvert-leur-...
en-2012-2353. Accessed: 4 December 2012.

Johnson, M., Sabin, C., Girardi, E. (2010) Definition and epidemiology of late presentation in Europe.
Antiviral Therapy,15(Supp 1):3-8.

Kim, N., Lucchetti, A., Whittington, W., Zuckerman, R., Coombes, R., Corey, L., Sanchez, J., CElum, C.
(2006) Higher rectal HIV RNA levels in men who have sex with men (MSM) with concurrent rectal HSV
shedding. 44th Annual Meeting of the Infectious Diseases Society of America, Toronto, abstract 57.

Kivelä, P.S., Krol, A., Salminen, M.O.,Ristola, M.A. (2010) Determinants of late HIV diagnosis among different transmission groups in Finland from 1985 to 2005. HIV Medicine, 11(6):360-367.

Krentz, H.B., Auld, M.C., Gill, M.J. (2004) The high cost of medical care for patients who present late (CD4 <200 cells/mm³) with HIV infection. HIV Medicine,5:93-8.
Levy, J.A. (1993) Pathogenesis of human immunodeficiency virus infection. Microbiological Reviews,
57:185–289.

Lert, F. and Pialoux, G. (2010) Numéro thématique – L’infection à VIH-sida en France en 2009: dépistage, nouveaux diagnostics et incidence. Bulletin Epidemiologique Hebdomadaire, 45-46:449-476.

Lo, Y., Wu, P., Hsieh, C., Chen, M., Shen, W., Hsieh, S., Sun, H., Liu, W., Hung, C., Chang, S. (2011) Late
diagnosis of Human Immunodeficiency Virus infection in the era of highly active Antiretroviral Therapy:
role of socio-behavioural factors and medical encounters. Journal of the Formosan Medical Association,
110(5):306-315.

Liuzzi, G., Chirianni, A., Clementi, M., Bagnarelli, P., Valenza, A., Cataldo, P.T., Piazza, M. (1996) Analysis
of HIV-1 load in blood, semen and saliva: evidence for different viral compartments in a cross-sectional
and longitudinal study. AIDS, 10:F51-F56.

Mandalia, S., Mandalia, R., Lo, G., Chadborn, T., Sharott, P., Youle, M., Anderson, J., Baily, G., Brettle, R., Fisher, M., Compels, M., Kinghorn, G., Johnson, M., McCarron, B., Pozniak, A., Tang, A., Walsh, J., White, D., Williams, I., Gazzard, B., Beck, E.J. (2010) Rising population cost of treating people living with HIV in the UK, 1997-2013. PLoS One, 5, 12: e15677.

Mignone, J., Migliardi, P., Harvey, C., Davis, J., Madariaga-Vignudo, L., Pindera, C. (2014) HIV as Chronic Illness: Caregiving and Social Networks in a Vulnerable Population. Journal of the Association of Nurses
in AIDS Care, 26(3):235–245.

Milligan, C., and Overbaugh, J. (2015) The role of cell-associated virus in mother-to-child HIV transmission. Journal of Infectious Diseases, 210 (Supplement 3):S631-40.

Mukolo, A., Villegas, R., Aliyu, M., Wallston, K.A. (2013) Predictors of Late Presentation for HIV
Diagnosis: A Literature Review and Suggested Way Forward. AIDS and Behaviour, 17(1):5-30.

Ndiaye, B., Salleron, J., Vincent, A., Bataille, P., Bonnevie, F., Choisy, P., Cochonat, K., Fontier, C.,
Guerroumi, H., Vandercam, B., Melliez, H.,Yazdanpanah, Y. (2011) Factors associated with presentation to care with advanced HIV disease in Brussels and Northern France: 1997-2007. BMC Infectious Diseases, 11(1):11

O’Connor, S.J., Manship, S., Hart, M., Tudor, F., Clift, S. (2014a) Phase 1 Research Report on the IMPRESS Health 2 (Interreg IVA Channel Programme) Project 4155: Understanding factors behind the late testing and diagnosis of HIV. ISBN 978-1-909067-31-8. Available at:
http://create.canterbury.ac.uk/12830/

O’Connor, S.J., Clift, S., Diouf, M., Lorenzo, P., Manship, S., Trouillet, H., Schmit, J. (2014b) Phase 1 Anglo-French Research Report on the IMPRESS Health 2 (Interreg IVA Channel Programme) Project 4155: Understanding factors behind the late testing and diagnosis of HIV. ISBN 978-1-909067-37-0.

Paz-Bailey, G., Raymond, H.F., Lansky, A., Mermin, J. (2014) Using the National HIV Behavioral Surveillance System to inform HIV prevention efforts in the United States. AIDS Behaviour, 18 (Supplement 3):S233-6.

Pereira, G., de Souza, S., Caetano, K., Martins, R., Gir, E., Minamisava, R., Gomes, J., Teles, S. (2011) Late HIV diagnosis and survival within 1 year following the first positive HIV test in a limited-resource region. Journal of the Association of Nurses in AIDS Care, 22(4):313-319.

Public Health England (2015) Sexual and reproductive health in England: A guide to local and national
data (Revised December 2014). [Online]. Available at:
https://www.gov.uk/government/uploads/system/uploads/attachment_data...
to_National_Local_Sexual_Reproductive_Health_Data.pdf. Accessed 24 April 2015).

Public Health England (2013) HIV in the United Kingdom: 2013 Report. London: Public Health England.

Pudney, J., Oneta, M., Mayer, K., Seage, G., Anderson, D. (1992) Pre-ejaculatory fluid as potential vector for sexual transmission of HIV-1. Lancet, 340:1470.

Rashbrook, E. (2013) HIV Prevention Needs Assessment for London. London: Public Health England.

Ross, P., Humble, A., Blum, I. (2013) Sexuality and HIV/AIDS: An Exploration of Older Heterosexual
Women's Knowledge Levels. Journal of Women & Aging, 25(2):165-182.

Rousseau, C.M., Nduati, R.W., Richardson, B.A., Steele, M.S., John-Stewart, G.C., Mbori-Ngacha, D.A,
Kreiss, J.K., Overbaugh, J. (2003) Longitudinal analysis of HIV type-1 RNA in breast milk and its relationship to infant infection and maternal disease. Journal of Infectious Diseases. 187:741-46.

Savasta, A.M. (2004) HIV: Associated transmission risks in older adults: An integrative review of the literature. Journal of the Association of Nurses in AIDS Care,15:50-59.

Schrantz, S.J., Babcock, C.A., Theodosis, C., Brown, S., Mercer, S., Pillow, M.T., Watts, K., Taylor, M., Pitrak, D.L. (2011) A targeted, conventional assay, Emergency Department HIV testing program integrated with existing clinical procedures. Annals of Emergency Medicine, 58(1):S85-S88.

Schwarcz, S., Richards, T.A., Frank, H., Wenzel, C., Hsu, L.C., Chin, C.J., Murphy, J., Dilley, J. (2011) Identifying barriers to HIV testing: personal and contextual factors associated with late HIV testing. AIDS Care, 7:892-900.

Shugars, D.C. and Whal, S.M. (1998) The role of the oral environment in HIV-1 transmission. Journal of the American Dental Association, 129:851-858.

Sudarshi, D., Pao, D., Murphy, G., Parry, J., Dean, G., Fisher, M. (2008) Missed opportunities for diagnosing primary HIV infection. Sexually Transmitted Infections, 84:14-16.

Sullivan, A.K., Curtis, H., Sabin, C.A., Johnson, M.A. (2005) Newly diagnosed HIV infections: review in
the UK and Ireland. British Medical Journal, 330:1301-2.
THT. HIV postal test. [Online]. Available at: http://www.tht.org.uk/sexual-health/HIV-STIs/HIVAIDS/
HIV-postal-test. Accessed 12 February 2014.

UNAIDS (2012) Global Report: UNAIDS Report on the Global AIDS Epidemic 2012. [Online]. Available
at: http://www.unaids.org/en/resources/publications/2012/name,76121,en.a... Accessed 24 April 2015.

Vives, N., Carnicer-Pont, D., Garcia de Olalla, P., Camps, N., Esteve, A., Casabona, J. (2012) Factors associated with late presentation of HIV infection in Catalonia, Spain. International Journal of STD & AIDS, 23:475-480.

WHO/UNAIDS/UNICEF (2011) Global HIV/AIDS Response: Epidemic update and health sector progress
towards Universal Access 2011. [Online]. Available at:
http://www.who.int/hiv/pub/progress_report2011/en/. Accessed 24 April 2015.

World Health Organisation (2007) Guidance on provider-initiated HIV testing and counselling in health facilities. Geneva: World Health Organisation.

Wohlgemut, J., Lawes, T., Laing, R.B.S. (2012) Trends in missed presentations and late HIV diagnosis in
a UK teaching hospital: a retrospective comparative cohort study. BMC Infectious Disease, 12(72).

Yang, B., Chan, S., Mohammad, N., Meyer, J., Risser, J., Chronister, K.J., Wolverton, M., Arafat, R., Hwang, L. (2010) Late HIV diagnosis in Houston/Harris County, Texas, 2000-2007. AIDS Care, 22(6):766-774.

Yazdanpanah, Y., Lange, J., Gerstoft, J., Cairns, G. (2010) Earlier testing for HIV – how do we prevent late presentation? Antiviral Therapy, Supp 1:17-24.

Zoufaly, A., an der Heiden, M., Marcus, U., Hoffmann, C., Stellbrink, H., Voss, L., van Lunzen, J., Hamouda, O. (2012) Late presentation for HIV diagnosis and care in Germany. HIV Medicine, 13(3):172-181.