Forty-four studies were included, of which the majority were conducted in the USA (38 of 44), nine in Europe (eight in the UK and one in Spain), three in Australia and one in Canada (Table 1). Five studies [17-21] provided nontargeted testing to the general population, while the rest addressed HIV testing in one or more high-risk populations. Eleven studies investigated HIV testing in multiple high-risk groups [21-31]. The most commonly targeted group for testing was MSM (17 studies, including two that specifically targeted BME MSM) [23, 27, 32-46]. Other groups included IDUs, youth, homeless individuals and individuals from Black and minority ethnic groups. HIV testing

was offered at a wide range of sites. Stand-alone HIV testing sites (14 studies [18, 20-22, 26, 34, 41, 43, 47-52]) and mobile clinics (11 studies [17, 21, 23, 24, 28-30, 36, 53-55]) were the most frequently selected sites for community BMN673 testing. Several studies conducted testing in venues known to CHIR-99021 supplier be frequented by the target population, for example drug treatment centres for IDUs [25, 27, 56, 57] or gay bars [39, 40, 45] and sex on premises venues [27, 33, 35, 38, 44, 46] for MSM. Ad hoc testing events were used as another method of providing HIV testing in the community [37, 42, 58]. Uptake of testing, defined as the proportion of individuals offered tests who accepted, was reported in 14 studies (for 16 different

testing models) [24, 27-29, 31, 38, 40, 42, 45, 47, 49, 50, 57, 59]. Uptake rates of HIV testing ranged from 9 to 95% and are difficult to compare given the diverse settings and offer methods (Fig. 2). For example, the 9% uptake of testing was reported in a study where every third

man entering a bar in the USA was offered a test [40]. In contrast, the 95% uptake was reported in a mobile clinic, although in this model uptake was measured among individuals who were either recruited by outreach workers on the street or who walked into the van of their own accord [28]. The proportion of clients tested who were newly diagnosed with HIV infection was reported in 34 of the included studies (Table 2). Seropositivity ranged from 0 to 12%, with the highest seropositivity reported from a study that tested transgender people at a variety of community sites [51]. In all studies targeting MSM and two of four studies mafosfamide in BME communities, the seropositivity was 2% or higher. In those studies where HIV testing was not targeted at high-risk populations, lower seropositivity was observed, but was at least 1% among those tested [17-20]. In all studies where no new diagnoses were made [26, 47, 49, 52], HIV testing was included as part of a bundle of tests for multiple STIs. These studies tested a small number of individuals (between 21 and 116 tests). Three of these studies [26, 47, 49] were conducted in services that targeted young adults and, although no HIV diagnoses were made, these services did identify and treat a number of individuals with bacterial STIs.