Table 4 Main outcomes: recommendations and next steps
Italy | Lithuania | Poland | Croatia | |
|---|---|---|---|---|
Integrated testing policies/strategies | Include monitoring of integrated testing in the national testing policies/strategy | Consolidate current guidelines in terms of HIV/HCV/HBV/STI screening and treatment. Treat rapid testing as a non-medical procedure and indicator to further diagnosis in a medical setting. Move confirmatory tests from community to medical health care setting. HIV should lose its privileged status of the protection of the anonymity of the client. Introduce unique identifier in all testing facilities. Lower legal testing age from 18 to 16 | Adapt National Testing Strategy to include new recommendations on integrated testing | |
Diversification of testing strategies | De-medicalize rapid testing and authorize the administration of rapid testing by lay providers Develop a policy on self-testing | De-medicalize rapid testing and scale-up of testing by GPs | De-medicalize rapid testing (classify as a non-medical procedure). The whole range of combined prevention should be introduced | De-medicalize rapid testing, including self-tests, to provide more accessibility |
Stigma and discrimination | Include into the national strategy measures to address stigma in the community and among professionals | Educate doctors on testing (e.g. a guidance on how to offer testing for different STI). There should be a possibility to do the test out of the medical setting (community testing) | Develop tangible solutions including education of GPs/health care staff/medical students and form network of LGBT-friendly GPs | |
Focus on key populations | Develop national guidelines on Partner Notification | Promote testing uptake among people at high risk and strengthen linkage to care | Establish pathways for confirmatory testing in community testing and for linkage to care | Focus testing on MSM, sex workers and PWID, and minimise loss to care |
Cost effectiveness | Conduct analysis of testing strategies | Conduct analysis provide rationale for more testing | Conduct analysis provide rationale for more testing | |
Surveillance | Develop a uniform way of collecting data from community testing sites | Strengthen documentation, data and cross sector collaborations | Epidemiological data to indicate key populations | |
Funding | Secure effective use of existing funds | Secure funds – local level, national and EU funds | Secure funds – local level, national and EU funds | |
Next steps | Follow-up meeting to be arranged by Ministry of Health to discuss the relevant issues | Follow-up meeting to be arranged by Ministry of Health to start | Cooperation to be strengthened between stakeholders, experts, institutions and government. Inclusion of findings and pilot recommendations into the next edition of the National HIV Programme (in June 2020) | Proposed changes to be presented at the National AIDS Commission meeting |