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BC Point of Care HIV Testing Program

The BC Point of Care (POC) HIV Testing Program provides POC tests to BC health care settings that meet program standards and have approval from their regional Health Authority.
Description

In 2012, a provincial framework for HIV (Hope to Health: Towards an AIDS-Free Generation) was outlined establishing the following goals for HIV testing, treatment, prevention and care in BC:

  • Reduce the number of new HIV infections;
  • Improve the quality, effectiveness and reach of HIV prevention services;
  • Diagnose those living with HIV early in their infection;
  • Improve the quality and reach of HIV support services for those living with and vulnerable to HIV;
  • Reduce the burden of advanced HIV infection on the health system.

Within the provincial framework, the BC HIV Point of Care (POC) Testing Program has supported HIV POC testing in all BC Health Authorities since 2011.

HIV POC testing is considered as one component of an overall strategy to provide access to HIV testing services. The Program provides POC tests and supplies them free-of-charge to BC health care settings that meet the program standards and have approval from their regional Health Authority.

BC has adopted a model to guide the development of HIV testing services based on the expected prevalence of HIV in specific settings or populations. The Conceptual Model for the Implementation and Evaluation of HIV Testing Strategies in BC shows where HIV testing by POC is suggested as an additional HIV test tool:

The Conceptual Model for the Implementation & Evaluation of HIV Testing Stragegies in BC1


1 Adapted from the Conceptual Framework for the Vancouver Coastal Health HIV Testing Program developed by R. Gustafson, M. Thumath, K. MacPherson, C Buchner (2013): Vancouver Coastal Health.

Priorities for use of HIV POC test kits within the BC Program are for community/outreach/health settings with one or more of the following characteristics:

  • The prevalence of undiagnosed HIV is expected to be high.
  • Not returning for test results is common among those being tested.
  • Individuals are reluctant to test because of perceived or real community HIV bias.
  • Provision of this test result is expected to improve public health follow-up or connection to HIV clinical care.

Providing a HIV test through POC has many potential benefits:

  • Increased acceptance of HIV testing among some individuals.
  • Individuals undergoing HIV POC testing are more likely to receive their test result,
  • The rapid turnaround time associated with HIV POC testing can guide urgent decision‐making to prevent HIV infection or to improve patient care.

All of these may result in timelier detection of HIV, resulting in improved clinical outcomes; as well as to potentially reduce possible secondary infections.

HIV testing through POC also has challenges:

  • Confirmatory testing of HIV POC results is not immediately available at the time of testing.
  • The likelihood of false positive results is higher in populations at low risk of HIV infection.
  • HIV POC testing may lead to decreased uptake of testing for other infections which may also be indicated (e.g. HCV, syphilis).
  • HIV POC testing does not capture early HIV infections (i.e. acute HIV).
  • Cost

For more detailed information please read the 2010 paper "Impact and Use of Point of Care HIV Testing: A Public Health Evidence Paper" accessed in the "Related Documents and Links" section on this page.


The HIV POC test uses specially designed kits which use a few drops of capillary blood (obtained by a finger prick) to provide a test result in a few minutes. POC tests are usually provided by a nurse or doctor, but can also be provided by other health care professionals or other staff, following the completion of specific training. 


The BC HIV POC Testing program provides POC tests and supplies to health care settings that meet the program standards and have approval from their regional Health Authority.

If you wish to inquire about support for your organization, please:

  1. Read the information on the Location Start Up page (middle tab in page options at the start of this page).
  2. Contact the appropriate Health Authority representative by clicking on the Health Authority Contacts Table. Each Health Authority has a process for review and approval of applications for support.
  3. Send an email to pocinfo@bccdc.ca


Location start-up

Any health care setting in BC may be eligible to be a POC testing location with the provincial POC program  - this may include public and First Nations/Aboriginal health units, physician and nurse practitioner practices, and non-governmental organizations. 

Test kit resources are limited and allocated per year, per regional Health Authority, based on population size and burden of HIV disease. Health Authority partners (see Table) decide where and how these resources are allocated based on their HIV Testing Implementation Plans.

Not all applicants are approved for a given fiscal year, and the level of support may change over time, based on what kit resources are available.

Health Authority partners collaborate with First Nations/aboriginal community representatives to discuss HIV testing needs in communities falling within their geographic area.

Resources may be available for single testing events such as Health/Wellness Fairs. Please discuss with your appropriate Health Authority partner.

There are several steps to request access to HIV POC test kits, and/or support as a testing location:

  • work with your health authority / health director to assess readiness for POC in your community (see Readiness Checklist and Implementation Considerations in Resources)
  • contact the Provincial POC HIV Testing Program and Health Authority partners to discuss the possibility of POC implementation or one-time use
  • receive training about HIV testing and how to use the POC test kit (see the courses in Education & Development)
  • ensure that your site is ready for testing and storage of POC test kits and quality control materials

The provincial POC program provides program resources including modifiable templates and guides to assist in the set up of new sites and to support existing ones (see Resources).

If you are interested in offering POC HIV testing at your location, please contact the program to receive further information about the test and the steps for implementation.

Resources
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SOURCE: BC Point of Care HIV Testing Program ( )
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