STI and HIV testing to break the chain of infection: Local innovation in the midst of COVID-19

Background: The national lockdown in March 2020 for COVID-19 resulted in the cessation of asymptomatic screening, and as a large network of sexual health clinics in North West England, this left many patients untested However, as we came out of lockdown, it presented a unique opportunity to test high-risk individuals at a time when their sexual risk-taking behaviour was likely to be at its lowest and when they were at the end of infection window periods, thus breaking the chain of infection Methods: A significant proportion of our cohort come under the BHIVA HIV testing guidance [1];therefore, before the lockdown measures were relaxed, we identified 1413 patients considered at particularly high risk These patients were sent a text inviting them to do a home test kit (HTK), including a dried blood spot for HIV Results: From 1413 texts sent, 324 (22 9%) responded and requested testing Of these 324, we have received 209 (64 5%) HTKs back to date These were predominantly White British (71 8%), male (95 2%) and MSM (92 3%), with a median age of 31 (range 18 to 61) 71 3% had not tested for over three months at the time of their HTK New STIs were identified in 38 (18 2%) patients, including one new HIV diagnosis Of the 115 who requested kits, but have not returned them, 48 5% had testing in the three months preceding the text, in keeping with BHIVA guidance, which may explain the lower return rate;our usual HTK return rate is around 70% Conclusions: COVID-19 has had a negative impact on STI and HIV testing;however, in such unusual times a cheap targeted intervention such as this was effective in detecting a significant number of infections This local intervention complemented national HIV testing campaigns [2] with the additional benefit of full STI screening and local linkage into care As a service, we will review the utility of sending three-monthly reminder texts to patients at higher risk Our intention is to approach those who did not respond, to help us better understand what strategies and measures we can put in place to support them to test