“Arica tiene VIH, ¿y tú?” El rol del test rápido de VIH en el diagnóstico oportuno para jóvenes de la comuna de Arica, Chile / Arica has HIV, and you? The role of the rapid HIV test in the timely diagnosis for young people in the district of Arica, Chile

Abstract

Research question: How is the rapid HIV test useful in assuring access to timely diagnosis of HIV for young adults in the city of Arica, Chile? Objectives: The primary objective of this study is to evaluate the rapid HIV test as a means of increasing access to timely diagnosis of HIV among those aged 18 – 29 in the community of Arica, which participated in a pilot of the rapid test in early 2018. The study sets out to evaluate the installation of this pilot to situate the role of the rapid test in Chile’s HIV landscape. Further objectives include the characterization of the demand for the rapid test, the identification of key barriers to timely diagnosis of HIV among the specified risk population, and an understanding of how the rapid HIV test addresses these barriers. Finally, this study aims to make recommendations for future national policies. Background: The incidence of HIV in Chile has risen dramatically in the last 10 years, and it is estimated that up to half of the 70,000 to 100,000 people living with HIV in Chile are not aware that they carry the virus. The region of Arica and Parinacota has the highest rate of HIV/AIDS in the country, especially among young adults. Until the end of 2017, only the ELISA test to diagnose HIV has been available within the public healthcare system. The ELISA can require up to three months to confirm, while the rapid test is considered less invasive and delivers preliminary results within 15 minutes. The national Ministry of Health approved a pilot of 8,000 rapid HIV tests in the family health centers of Arica in the beginning of 2018; however, there are currently no studies on its efficacy. A better understanding of the results of the pilot could improve the future implementation of the rapid test into the public healthcare system and target existing barriers to diagnosis. Methodology: This study is comprised of 73 anonymous questionnaires by students of the University of Tarapacá and interviews with five experts involved in the pilot of the rapid test. It also uses ArcGIS to map the geographic access to the HIV exam in the city of Arica. The interviews were analyzed and compared by common themes. The surveys were analyzed quantitatively using Microsoft Excel. However, they do not represent a significant sample of the population and therefore represent the perceptions and experiences of respondents. Results: The surveys demonstrated a mediocre knowledge of where the pilot of the rapid test was being conducted in the city. It further indicated that primary barriers to testing among young adults include time and low knowledge of the testing process. 47% of those surveyed had been tested for HIV at least once, 59% having realized rapid tests. The most rapid tests took place outside of the public health system. The expert interviews revealed an initial lack of proper guidance and human resources during the pilot. Overall, the professionals believed that the rapid test was an effective tool for timely diagnosis in Arica if paired with improved sexual education