Research Update: What can we learn from an American HIV testing campaign?
A study on the effect that National HIV Testing Day (NHTD) has on HIV testing trends in the United States showed an increase in both the number of tests performed and new HIV-positive test results during the week of NHTD compared to two control weeks. The study also showed significant increases in the percentage of HIV tests in high-risk populations, including men who have sex with men (MSM) and non-Hispanic Black people.
National HIV Testing Day is used in the United States to promote and increase HIV testing. The event takes place annually on June 27th and hundreds of local events take place. Most local events offer HIV testing and are accompanied by media and social marketing campaigns that improve knowledge about HIV prevention, testing and care services; address barriers to getting tested; and encourage HIV testing.
The objectives of National HIV Testing Day are to encourage people to:
- get tested for HIV
- become aware of their HIV status
- get linked to prevention, care, and treatment services
- work to reduce the stigma associated with HIV
Although NHTD has been running in the United States since 1995, no such day has ever been established in Canada.
The week around NHTD in 2010 (June 24–30) was compared to two other weeks that year, called control weeks. These weeks (control week 1: January 7–13 and control week 2: August 12–18) were chosen because no known HIV testing or awareness campaigns were conducted nationally within four weeks of these periods and no major national holidays were within a week of these periods.
In 2010, 52 health departments conducted 161,844 CDC-funded testing episodes during the three weeks included in the study. During NHTD week in 2010, there were significantly more tests conducted compared to both the control weeks (63,914 tests compared to 48,748 tests during control week 1 and 49,182 tests during control week 2).
During NHTD week, there were significantly more newly identified HIV-positive test results compared to both control weeks (467 during NHTD week compared to 367 in control week 1 and 356 in control week 2).
The profile of people who tested also changed during NHTD. The study showed that, compared to control weeks 1 and 2:
- The percentage of people aged 20–29 who tested during NHTD week was significantly lower (4.5% and 1.8% lower, respectively).
- The percentage of people aged 50 years of age or older who tested during NHTD week was significantly higher (2.7% and 1.6% higher, respectively).
- The percentage of people who were non-Hispanic white who tested during NHTD week was significantly lower (2.8% and 1.4% lower, respectively).
- The percentage of people who were non-Hispanic Black who tested during NHTD week was significantly higher (2.9% and 1.9% higher, respectively).
- The percentage of people who were MSM who tested during NHTD week was significantly higher (0.8% and 1.0% higher, respectively).
- The percentage of people who were low-risk heterosexuals who tested during NHTD week was significantly higher (2.0% and 1.8% higher, respectively).
The study showed that during NHTD week, the percentage of people who were tested with a rapid test compared to control weeks 1 and 2 was significantly more (6.6% and 4.9% more, respectively). The study also found that the percentage of people tested in a non-healthcare setting during NHTD week compared to control weeks 1 and 2 was significantly higher (13.1% and 10.1% higher, respectively). Finally, compared to control week 1 (but not 2) the percentage of people who received their test result was significantly higher (3.0%).
What does this tell us about the potential of a National HIV Testing Day in Canada?
This study showed that NHTD increased overall testing numbers and newly identified HIV-positive test results compared to two control weeks. It also demonstrated an increase in testing among certain high-risk populations, including non-Hispanic Black people and MSM but not among others, such as Hispanic or Latino people.
The use of rapid test technology – 66% of all tests performed during NHTD were rapid tests – may have been key to increasing the ability of service providers to perform more tests. The expansion of testing sites to non-healthcare settings during the campaign may also have been important. High rates of returned test results (81%) during NHTD week tells us that a majority of testers learned their HIV status.
A similar national HIV testing day in Canada could potentially increase the number of people who test for HIV and therefore know their status. An understanding of the barriers to testing among specific at-risk populations should be used to better inform the social marketing approaches of any campaign to ensure that these barriers are addressed.
HIV Screening and Testing Guide – Public Health Agency of Canada
- 1. Van Handel MM, Mulatu MS. Effectiveness of the U.S. National HIV Testing Day campaigns in promoting HIV testing: Evidence from CDC-funded HIV testing sites, 2010. Public Health Reports. 2014 Oct;129:446–54.