The testing history of those individuals attending community settings was reported in 15 studies, with 13 of 15 showing that the large majority of clients (between 62 and 100%) had previously had an HIV test [18, 27, 31, 33, 34, 36, 41, 43, 47, 51, 59, 60] and only two studies [17, 25] reporting that < 50% of people attending had tested previously. Both of these studies used mobile vans to offer HIV testing and one targeted BME communities in the USA [25], while the other,

conducted in Spain, did not target any particular high-risk group [17]. Only one study compared the testing history of all those who tested with the testing history of those who received a positive result. Overall, 14% of attendees had never previously been tested. However, among those who were newly diagnosed, this proportion was higher, at 24% [59]. Where included studies compared clients who tested in community selleck screening library settings with those attending more traditional testing services, such as sexual health or STI clinics, there were conflicting results. Two studies, one among MSM testing at a stand-alone HIV testing site in the UK [34] and one in Wisconsin, USA [19], showed that individuals attending community settings were less likely to receive a positive result than individuals

attending the local STI or traditional sexual health clinic. check details By contrast, a Los Smoothened Angeles, USA study found a higher seropositivity in MSM tested in a community setting

(5.3%) than among those tested at an STI clinic (3.9%) [43]. The fourth study showed that a similar HIV seropositivity was observed at a mobile clinic targeting BME populations compared with other testing sites within the same geographical area [55]. The proportions of patients who received their HIV test result ranged from 29 to 100% (data available for 16 studies) [17, 18, 20, 23-25, 27, 28, 33, 36, 38, 46, 51, 53, 57, 59]. Three studies, which conducted testing from mobile vans, had < 50% return rates (using oral fluid [36, 53] or serological testing [24, 53]). The use of rapid tests consistently resulted in higher proportions of individuals receiving their results (>80%) compared to when laboratory blood or salivary tests were used (five studies) [18, 20, 23, 27, 46]. Only three studies reported the proportion of those patients who received a positive HIV test result who were successfully linked to care, and this was 75% [33] and 100% [34, 38]. Overall, where reported, client satisfaction with community testing services was high (Table 3). Choice of test type [20], use of a noninvasive test [52], anonymous testing [21, 44], confidentiality and the test being free of charge [21] were cited as important factors by clients in choosing to test for HIV. Three studies showed that rapid testing was preferred by clients [18, 20, 27].