The XLII Spanish Epidemiology Society (SEE) meeting took place from September 10th to 13th, 2023 in Cadis, Spain. Three abstracts were presented by COBATEST network at the meeting.

Dr. Laura Fernàndez-López presented an abstract based on data collected by COBATEST network members analyzing the increase of integrated testing for HIV, HCV and syphilis in community-based testing services looking at 2014 to 2023. The number of testing sessions where more than one test was conducted increased during the study period, from 48.38% of all testing sessions in 2014 to 82.19% in 2023 (an increase of 69.88%). Considering all testing sessions over the entire period, 44.0% involved both HIV and syphilis tests, 35.9% involved only HIV tests, 13.6% involved the 3 tests, 5.4% involved both HIV and HCV tests, and only 1.3% and 0.3% of testing sessions exclusively performed HCV tests and syphilis tests, respectively. The number of testing sessions where all 3 tests were conducted increased by 617.2% in 2023 compared to 2014, rising from 1.7% of all testing sessions to 56.1%. 

The prevalence of reactive tests for the three infections at the same testing session over the entire period was 0.18% of all testing sessions where the 3 tests were performed. The prevalence for HIV and syphilis reactive tests was 1.5%, 0.0% for HIV and HCV, and 0.5% for Syphilis and HCV.

Please find full presentations online.

Second abstract presented by Dr. Laura Fernàndez-López analysed bio-behavioral trends related to HIV/STIs in key populations based on data from theCOBATEST Network from 20213 to 2022. 103,644 visits, of which 2,290 were for transgender individuals (TG), 48,005 for gay, bisexual, and other men who have sex with men (GBHSH), 1,356 for sex workers (PID), and 19,772 for non-EU migrants. Significant changes were observed (p<0.05) in the trend of previous HIV testing in TG, where there was an increase in individuals who had never been tested for HIV. Regarding vaccination coverage against hepatitis A (VHA), an upward trend was observed since 2019 in GBHSH, PID, and transgender individuals, while in migrants, the upward trend began in 2018 but showed a decline in 2022. Vaccination coverage against hepatitis B (VHB) showed an upward trend since 2018 in GBHSH, transgender individuals, and migrants, with a decline in the latter group in 2022. The prevalence of STIs in the last 12 months among TG, GBHSH, PID, and transgender individuals showed an increasing trend until 2020, reversing the trend in 2021. The use of condoms showed a downward trend since 2020 among TG, GBHSH, and transgender individuals, while it increased among PID since 2020, and a decline was observed among migrants since 2018. 

Please find full presentations online.

Third abstract presented by Dr. Laura Fernàndez-López based on data collected by COBATEST network members in 2023 discussed healthcare access and STIs Among Beneficiaries of Community-Testing Centres in Europe and Central Asia in 2023. In total, 12,564 persons were tested for STI. Out of total, 88.95% (n=11,176) had access to care, 7.74% (n=973) had STI-diagnoses, and 4.93% (n=48) had both STI and HIV-diagnoses. Among the group of those who had an STI diagnosis, cis men (73.4%), the age group of 26 to 35 years (40.3%), and those who tested positive for HIV were more represented. The percentage of those with access to healthcare services is also higher in this group, although it is not statistically significant. The percentage of MSM (67.8%) and SW (12.9%) were also higher in the group of those with an STI diagnosis compared with those without STI diagnosis, and PWID percentage (2.9%) was lower. Compared to other key-population groups without access to care, migrants (7.75%, n=41) and sex workers (8.62%, n=20) had the highest prevalence of STI-diagnoses. Seventy-two percent (n=450) of people who inject drugs (PWIDS), reported not having access to care, and 75.5% (n=447) of the population-group didn’t have STI.

Cisgender women had a lower probability of STI-diagnoses compared to cisgender men [PR=0.37; 95% CI, 0.27-0.51; p<0.001]. The probability of STI-diagnosis among MSM compared with rest of the population was 5.84 [95%CI, 4.42-7.87; p<0.001]. The probability of STI-diagnoses among MSM without access to care was 9.89 [CI 95%, 2.27-40.18; p<0.001] compared to rest of the population without access to care.

Please find full presentations online.

COBATEST participated on July 27-29 at the CORE mid-term meeting in Berlin hosted by Aids Action Europe. The CORE project (Community Response to End Inequalities) aims to reduce inequalities in the HIV, TB and viral hepatitis responses that have proven key in reaching communities that have been traditionally underserved by mainstream prevention and healthcare services. As the first 18 months of the project have passed, the work packages and implementing partners updated each other on the progress of the work done, challenges, and expectations for the next 18 months.

The first COBATEST Steering Committee meeting for 2024 was held in Zagreb, Croatia, on May 30th and 31st. For the first time, the meeting was hosted not in the secretariat’s country, but in the home country of a Steering Committee member. This year, Davor Dubravic from the HUHIV organization in Croatia served as the host. Additionally, the meeting marked the debut of two new committee members, Nino Tsereteli from the Tanadgoma organization in Georgia and Mihai Lixandru from the ARAS organization in Romania. The Steering Committee discussed the planning of the 2024 SC elections, the annual COBATEST members’ meeting, potential funding opportunities, and other COBATEST activities to support the network’s members.

The third BOOST project (dedicated to boosting access and quality of community-based communicable disease services for PWUD in the EU and neighboring countries) in-person partner meeting took place on May 27th and 28th in Antwerp, Belgium. Twenty-one representatives from BOOST members traveled to Antwerp to discuss the project’s progress and plan its development during the second year since its inception. Dr. Fernandez and Dr. Gogishvili presented the step-by-step adaptation process of the COBATEST data collection tool to meet the needs of Harm Reduction HIV/STI testing centres that took place in the fall of 2023. The adaptation was approved by experts in the fields of Harm Reduction and academia. This work was done in parallel with efforts by the CORE (Community Response to End Inequalities) project which focused more on other key population groups. Both CORE and BOOST projects are co-funded by the European Union. The next steps involved development and implementation of communication strategies to disseminate information about the COBATEST standardized data collection online tool to harm reduction centers offering testing services.

On February 28th, 2024, COBATEST participated in BOOST’s Digital Skills online training on the Role and Specifics of Digital Services in the Package of HIV, HCV, TB, and STI Services for Key Populations, co-funded by the European Union. Dr. Gogishvili presented two digital tools created by COBATEST and utilized by its members: the online standardized data collection tool, which allows members to enter, store, and export all their testing data, and the online appointment tool, which enables tracking of all center appointments and allows clients to book appointments online. Both tools are available to COBATEST members for free. The training was highly successful and sparked interest in the COBATEST tools from other regions of the world that are not currently part of the network.

The AidsImpact conference took place from June 12th to 15th, 2023 in Stockholm, Sweden. Two abstracts were presented by COBATEST network at the conference.

Dr.Megi Gogishvili presented an abstract based on the quantitative and qualitative data collected through an online questionnaire from EECA members of COBATEST network, ECOM, AFEW, and Aids Action Europe in 2022. 

A presentation was conducted on the results of an assessment of operational and structural realities and obstacles encountered by CBVCTs in EECA during HIV/STI testing and data collection. The data was based on the assessment of 20 CBVCTS, 8 from Eastern European countries and 3 from Central Asian countries. Majority of CBVCTs (14/20) depended primary on international grants and only few (2/20) operated mainly on a local governmental funds. Target testing population of majority of the CBVCTs were MSM (15/20), PWIDs (13/20), and SW (12/20). While 13 of CBVCTs provided assistance on how to navigate national health systems, only 1 provided legal counselling. All CBVCTs tested for HIV, 17 of them on HCV, 13 on HBV, and only 3 on Syphilis. Only 5 CBVCTs could perform confirmatory tests in their centers. Fifteen CBVCTs provided self-testing kits, however only 2 always received results of the testing. All participating CBVCTs collected data, 14/20 utilized both online and offline tool. Data is mostly collected for donor reporting purposes. However, interest was shown in being able to utilize collected data for improving services provided, informing future projects, and publishing articles. Primary themes identified in challenges named while testing and collecting data were: lack of funding (for personnel, tests), confidentiality and stigma, and political environment of the countries (restrictive laws, war). Please find full presentation online.

Dr.Laura Fernandez Lopez presented an abstract based on quantitative data collected by COBATEST network members from 2013 to 2022.

A presentation was conducted on a key population belonging and HIV associated factors among 60 European community-led testing centers from COBATEST network. 73,799 HIV tested people were included in the cross-sectional study, of whom 65.3% (n=48,168) belonged to some key population. HIV reactive testing general prevalence was 1.68% (CI:1.59-1.78), while in key population was 2.41% (CI:2.27-2.55) and 0.31% (CI:0.25-0.38) in non-key population. In the multivariate analysis in key population group, being younger (aOR=0.99; CI:0.986-0.999), a man (aOR=6.05; CI:4.44-8.24) or a transgender (aOR=10.02; CI:7.07-14.20), being migrant from abroad the UE (aOR=1.76; CI:1.52-2.04), less condomless penetration during last sexual intercourse (aOR=1.36; CI:1.19-1.55), previous STI during last 12 months (aOR=1.41; CI:1.17-1.71) and doing sexual work (aOR=1.56; CI:1.27-1.91) were significantly associated with HIV reactive testing. In contrast, in non-key population, associated factors to HIV reactive testing were being older (aOR=1.03; CI:1.02-1.05) and a man (aOR=1.93; CI:1.17-3.19). Please find full presentation online