As part of the BC-CfE Forefront Lecture series, we welcomed Dr. Cong Jin, a virologist who is currently Deputy Director of the National HIV/HCV Reference Lab in the National Center for AIDS/STD Control and Prevention (NCAIDS) in China. Dr. Jin presented to a rapt audience of scientists and clinicians on the HIV testing laboratory network in China and the innovative strategies the country is developing to increase testing. This includes installing HIV testing kits in university vending machines.
In 2018 alone, over 240 million HIV tests were conducted in China. Despite significantly increasing the volume of tests, HIV detection rates have not increased accordingly in some regions over the past decade.
Dr Jin spoke about some innovative steps the NCAIDS has taken in the face of this public health threat to increase testing efficiency and help more people learn about their HIV status, thus narrowing the gap towards the first goal of the 90-90-90 targets.
Speaking about the need for the vending machine pilot project, Dr. Jin explained it was precipitated by two main factors, “China has experienced an upsurge in HIV infection rates among younger populations- this is thought to be linked to limited pre-college sex education and an increase in sexual openness.”
Dr. Jin explained how self-sampling HIV testing using university vending machines as a vehicle allows the students to collect urine samples at home. Students use a self-sampling kit which includes a special capped tube filled with a sponge as well as an instruction card which is then mailed to an accredited HIV testing laboratory. Results can be checked on a web platform or mobile app using the unique code printed on each self-sampling kit. Students can then link to further medical support and health care if needed.
“Up to May of 2019, 10 provinces had taken part in this project. We have received over 5,000 urine samples, with 67 of these testing positive for HIV. Not only are we raising awareness of the importance of testing and of the virus itself, this approach has other advantages- it is simple, convenient, protects confidentiality and provides linkages to professional supports,” Dr. Jin explained.
The NCAIDS also led pilot studies into the effectiveness of self-testing among the general population. As of August 2019, the first self-testing product, which uses urine samples, was approved on the Chinese market. Instead of testing in a health care setting, people can now get tested for HIV and get their results from home. They conducted two pilot studies – one where the kits were distributed through pharmacies, and the other which involved selling the kits online. From a study among men who have sex with men population, which ran from November to December 2017, over 27,000 kits were sold online. This indicated to the NCAIDS that there is a genuine need for more flexible testing options for those living in China.
“China is a huge country geographically, which in itself presents many challenges when it comes to ensuring there is ready access to testing and treatment for HIV, said Dr. Julio Montaner, Executive Director and Physician-in-Chief of the BC-CfE. “For Treatment as Preventionto be successful, it is essential to not only ensure adequate testing rates, but also immediate access to treatment for people living with HIV. I understand the challenges and constraints within the system in China at present which the NCAIDS is currently working through and we sincerely commend them for these innovative efforts.”
Exploring the availability of self-testing has been added to China’s National HIV Strategic Plan (2016-2020) and the NCAIDS formally issued national self-testing guidelines on October 2019 to provide a framework for expansion of these services throughout the country.
For upcoming BC-CfE Forefront Lectures, visit
https://education.bccfe.ca/calendar-of-events/.