HIV point-of-care testing in non-urban settings: A scoping review
Bibliographic record
Abstract
Although HIV point-of-care testing (HIV POCT) is available in many jurisdictions in Canada and elsewhere, challenges in access and uptake of POCT remain, particularly in non-urban settings. Our team undertook a scoping review of the HIV POCT peer-reviewed literature to determine how this type of testing could potentially be scaled-up in non-urban locations in Canada. We searched Ovid MEDLINE, EMBASE, EBM Reviews, PsycINFO and CINAHL. All English-Language, empirical quantitative and qualitative papers that examined the use of HIV point-of-care testing in non-urban areas including factors such as uptake, acceptability, loss to follow-up and linkage to care rates were included. We also identified models that use allied health professionals and/or provide testing outside of traditional clinical settings in efforts to improve access and uptake. We reviewed 3,142 references for eligibility and of these, 17 peer-reviewed studies met the eligibility criteria. HIV POCT programs were implemented and evaluated in non-urban settings, including community health centres, door-to-door outreach, hospital, pharmacy, primary care, prisons, and substance abuse clinics. The feasibility and acceptability of HIV POCT were demonstrated in diverse sites including dental offices, home testing, pharmacies, primary care, and sexual health/ HIV clinics. Innovative HIV POCT models are particularly relevant to non-urban settings, including attention to safeguarding privacy and confidentiality, improving overall health-care, and reaching diverse populations. However, testing innovations such as HIV POCT in non-urban communities in Canada will require additional research to understand how best to scale up novel approaches in contexts with limited or no current access to testing.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.021 | 0.097 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.004 |
| Bibliometrics | 0.022 | 0.033 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.006 | 0.004 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".