Feasibility of an innovative AideSmart! app-based multiplexed, point-of-care screening/counselling strategy for HIV-associated co-infections (HCV, Syphilis, HBV) in key Canadian populations

An estimated 40-50% of Canadians infected are unaware of their hepatitis C infection, 18-28% of their HIV, and 15-20% of their hepatitis B or syphilis infection. Gaps in timely access to care, population engagement, stigma and discrimination, limited clinic hours, limited testing in remote communities and long turnaround time for results lead to individuals not getting tested, or not coming back for their results, precipitate losses to follow up with conventional testing. Despite treatment availability, undiagnosed individuals fuel the ongoing transmission of these infections, and knowing one's co-infection status is the first step towards infection control. New simple rapid tests that can diagnose multiple infections with one device, together with mobile applications that can integrate counselling, quality testing, linkages to care, communications and data storage, make up a powerful strategy to potentially address the problem. We have recently successfully pilot tested this strategy in India with pregnant women in a remote setting. In this project, we will adapt and test our Smart App/Multiplex rapid testing, screening and counselling strategy in key populations residing in Ontario, Quebec, Alberta and Nova Scotia. For this, over a 3-year period, we will recruit 450 participants who will use the new strategy, and we will test how many participants complete the process (including testing, counselling and care), ask them about preference and acceptability. Data from this study will guide us for a clinical trial Canadawide.