Establishment of a national surveillance system to monitor community HIV testing, Ireland, 2018

Ir J Med Sci. 2020 Nov;189(4):1507-1514. doi: 10.1007/s11845-020-02217-3. Epub 2020 Apr 2.


Background: HIV continues to be an important public health issue. Voluntary community-based HIV testing (VCBT) helps to reduce the undiagnosed population of HIV-positive individuals, enabling early diagnosis and treatment. Monitoring is essential to determine whether at-risk groups are being effectively reached.

Aims: Our aim was to pilot and then introduce sustained monitoring of VCBT in Ireland, through collaboration between statutory and non-statutory organisations.

Methods: The study was initiated by the Health Protection Surveillance Centre in 2018. Steps included forming a multisectoral steering group and developing a minimum standardised dataset. De-identified case-based data were requested for VCBT carried out from 1 January 2017 onwards; this paper includes data for 2018.

Results: Six organisations participated; all four NGOs involved in VCBT, one medical charity, and the Health Service Executive National Social Inclusion Office. Methods were rapid point-of-care testing (POCT) (54%) or laboratory based (46%). Total HIV test reactivity was 1.7% (1.5% excluding persons later identified as previously diagnosed HIV positive). All POCT data were case based; the test reactivity rate was 0.8% and was higher in bar/club settings (1.2%). Most (74%) laboratory testing data were in aggregate format; the test positivity rate in one asylum centre was 5.0%. Ongoing challenges include testing among persons later identified as previously diagnosed HIV positive, monitoring case-based testing in asylum settings, and suboptimal data on confirmatory testing and linkage to care.

Conclusions: Sustained national monitoring in community settings will help inform HIV testing guidelines and will enable assessment of the impact of local and regional community HIV testing strategies.

Keywords: Community HIV testing monitoring; HIV; International protection applicants; Ireland; Men who have sex with men; Point-of-care testing; Surveillance.

Publication types

  • Historical Article

MeSH terms

  • Adult
  • Female
  • HIV Infections / epidemiology*
  • History, 21st Century
  • Humans
  • Ireland
  • Male
  • Mass Screening
  • Pilot Projects
  • Population Surveillance / methods*