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 IWR-1 concentration 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. selleck chemical By contrast, a Los Adenosine 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].