P131 Anlaids community-based HIV screening as a tool to improve HIV diagnosis among asymptomatic individuals

Background HIV testing is the first essential step on the path of reaching the UNAIDS global goal of ending AIDS as a public health threat by 2030. Since HIV-related stigma remains a key barrier to test access, Community Based Voluntary Counselling and Testing (CBVCT) may be more effective in addressing this issue. Anlaids has ever been committed to provide people with knowledge and skills to prevent HIV infection and other sexually transmitted infections (STIs). Following the availability or rapid HIV tests, many of the regional offices of Anlaids started to offer out-of-hospital HIV counselling and testing initiatives, often provided in conjunction with other infectious disease tests. Material and Methods Aim of the study was to evaluate the number of HIV tests conducted (testing volume) and the percentage of HIV-positive results obtained (positivity) in 12 different Anlaids offices located in 10 Italian regions, from northern to southern Italy. Five sites collected data on yearly basis from 2018 to 2024, 7 sites from 2020 to 2024. The data collection form allowed extrapolating subjects who received their first HIV test ever. Results From 2018 to 2024 11,424 rapid HIV test were done (41.9% salivary test, 58.2% blood test). Overall, male to female ratio was 61,1% to 38,9%; age distribution was: 43% 18–24 yo, 28% 25–30, 16% 31–40, 7% 41–50, 5% 51–64, 1% 65 or over; sexual behaviour was: 61% heterosexual, 34% MSM, 2.5% bisexual, 2.5% other/no response; Italians were 75%, foreigners 25%. The total number of positive tests was 87, with a positivity rate of 0.73%. Six out of 12 sites were able to extrapolate data on ‘first-ever-HIV-test’. The number of ‘first-ever-HIV-test’ was 4,185/8,989 (46.5%); the number of positive ‘first-ever-HIV-test’ was 15 out of 4,185, with a positivity rate of 0.36%. Conclusions In Italy, 8,000–10,000 individuals are estimated to be unaware of their HIV infection. Most of them are presumably asymptomatic, since national data on new HIV diagnoses in 2023 confirm the high frequency (35%) of people undergoing HIV test only when symptoms develop. Our data show that the positivity rate in a small sample of asymptomatic young individuals undergoing HIV test for the first time in their life in CBVCT setting is 0.36%. By applying this rate to the estimated number of people unaware of their HIV status, we can assume that at least 2.5 million tests should be carried out in a limited period of time (i.e. one year) to increase the chances of HIV diagnosing among asymptomatic individuals with medium-low risk profile and/or limited risk perception. By providing adequate counselling and prevention information (including pre-exposure prophylaxis) to all the people undergoing HIV testing, we could mark a key step towards the end of the epidemic in Italy.