HIV community testing finds higher reactivity rate in females than males

A higher proportion of females who were tested for HIV in a non-clinical setting received a positive result compared to males, a new analysis reveals.

The HSE report found that, while there was significantly more HIV testing of men than women in non-clinical settings that year, 1.3 per cent of females tested positive, compared to 0.6 per cent of males.

In total, 3,754 community-based HIV tests were carried out by five partner organisations, an increase of 19 per cent on 2022, when 3,142 tests took place. More than three-in-four tests were carried out on males.

Almost half of all testing (46.8 per cent) occurred in accommodation centres for international protection applicants. Other locations where community testing occurred include non-governmental organisation (NGO) headquarters (17.1 per cent), and bars or clubs (11.1 per cent).

Overall, 32 individuals had reactive test results, of which 24 were first-time diagnoses, six were previously diagnosed with HIV, and two had an unknown history. Excluding the six individuals with a previously known HIV diagnosis, the reactivity rate was 0.7 per cent.

Health officials found that 16 men and nine women received positive results. One transgender female was recorded with a positive result, but officials noted that reactivity rates among the transgender population may be underreported.

A total of 14 positive tests were found in international protection accommodation centres. Eleven of these were first-time diagnoses, and comprised of six men and five women.  In sauna and sex-on-premises venues, six positive results were revealed out of 124 tests carried out, representing the highest reactivity rate of any non-clinical setting, at 4.8 per cent.

“The reactivity rate seen in community settings where key populations live and socialise demonstrates the benefit of expanding testing beyond traditional health settings, reaching those who are underserved,” said the authors of the report ‘Monitoring community HIV testing in Ireland, 2023’.

“Community testing is part of a broader strategy to increase access to HIV testing, including home and self-testing. Combining these methods with facility-based testing enhances access and reduces the number of people living with HIV who are unaware of their status.”

The data found that first time testers had a higher positivity rate (1.5 per cent) compared to repeat testers (0.5 per cent).

Excluding groups with low numbers tested, positivity rates were highest among migrants from countries of high HIV prevalence (two per cent), followed by gay, bisexual, and other men who have sex with men (one per cent).

The report also noted other HIV testing data, including the uptake of the HSE’s free STI home-testing service which had its first full year in operation in 2023.

That year, the home-testing programme processed 57,516 completed tests for HIV. Of these, 16 were confirmed positive.

A reception centre for international protection applicants at Balseskin in north Dublin also provides opt-in HIV screening as part of a general health screening programme.

In 2023, 1,847 people were screened for HIV as part of this programme. In total, 79 (4.3 per cent) were confirmed HIV positive of which 14 (0.8 per cent) were first-time diagnoses. Of the 79, almost all (97 per cent) were from Sub-Saharan Africa.