FAST-HIV

Feasible, Accessible, Standard Testing for HIV (FAST-HIV) in the Emergency Department (ED) is a program framework and paired research project, created in response to recognizing barriers to accessing healthcare services, including HIV testing, for underserved communities and priority populations whose sole touchpoint with the medical system may be the ED. The goal is to make HIV testing and linkage to care more accessible, equitable, and efficient.
Prior to FAST-HIV, few HIV tests were ordered in the ED, and those that were, were sent offsite to Public Health Ontario laboratories. The results from these HIV tests required days to weeks to be returned, and providers were thus wary of offering or ordering HIV tests in the ED, out of a concern for lack of follow-up and continuity of care for some of Ontario’s highest needs populations. The lengthy turnaround time also meant that vital information that could directly impact acutely ill patients, was missing from their clinical workup.
FAST-HIV seeks to bridge this gap in care, and demonstrate fiscal responsibility and long-term economic efficiency in doing so. FAST-HIV is the result of four years of ideation, research, design, and quality improvement refinement to produce a feasible, accessible, and streamlined implementation framework, developed in collaboration with people living with HIV, emergency medicine physicians and nurses, and healthcare researchers.
FAST-HIV aligns with Canada’s commitment to achieving the UNAIDS 95-95-95 targets and is part of the Ontario HIV Treatment Network’s Toronto to Zero initiative. It was first implemented at the University Health Network, and in 2024, received additional funding from the Ontario HIV Treatment Network (OHTN) to support the expansion of the program and research project to multiple hospital systems provincially.

 

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FAST-HIV Project Team

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Jennifer Hulme

Co-Principal Investigator

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Megan Landes

Co-Principal Investigator

Monika Schmidt

Monika Schmidt

FAST-HIV Technical Director

Publications, Presentations and Media

Publications

  1. Kent JT, Puchalski Ritchie LM, Klaiman M, Dell EM, Garnett M, Landes M, Ginocchio GF, Alsefaou A. Barriers and facilitators to the implementation of rapid HIV testing in Canadian Emergency Departments: a mixed methods study. Canadian Journal of Emergency Medicine. 2024 Jul;26(7):463-71.
  2. El-Baba M, Kent J, Bogoch II, Vose K, Hulme J, Landes M. Rapid HIV testing in emergency departments: a paradigm shift. Canadian Journal of Emergency Medicine. 2024 Jan;26(1):7-9.

 

Presentations

  1. Schmidt M, Landes M, Papamihali K, McKnight A, Fremes E, Bogoch I, Brinc D,  Hulme J. FAST-HIV: 3-year sustainability of novel implementation of emergency department-offered STAT HIV testing. International Conference on Emergency Medicine (ICEM). Montreal Quebec, Canada. May 2025. (Oral Presentation)
  2. Hulme J, Schmidt M, Bogoch I, Fremes E, McKnight A, Brinc D, Landes M. Importance of STAT HIV testing in the emergency department for prevention: linkage to care for HIV-negative individuals. International Conference on Emergency Medicine (ICEM). Montreal Quebec, Canada. May 2025. (Poster Presentation)
  3. Schmidt M. Feasible, Accessible, Standard Testing for HIV: 3-year sustainability of novel implementation of Emergency Department-offered STAT HIV testing and linkage to care. Toronto Emergency Medicine Academic Day, University of Toronto. Toronto, Ontario, Canada. May 13, 2025. (Oral Presentation)
  4. Hulme J. FAST-HIV - why care about HIV in your ED? Humber River Hospital ED Physician Business Meeting. Virtual. April 3, 2025. (Oral Presentation)
  5. Papamihali K, Schmidt M. Feasible, Accessible, Standard Testing for HIV: 3-year sustainability of novel implementation of Emergency Department-offered STAT HIV testing and linkage to care. The Ontario Public Health Convention (TOPHC), Virtual Forum. Ontario-wide. April 2, 2025. (Oral Presentation). 
  6. Hulme J, Landes M, Foxton S. FAST-HIV in the ED - Provider Training Module and Special Lecture. ED Provider Special Lecture, Royal Victoria Regional Health Sciences Centre. Barrie, Ontario, Canada. April 1, 2025. (Oral Presentation)
  7. Barnes S. UHN Provider Information Module: FAST-HIV and FAST-HCV in the ED. UHN ED Physician Business Meeting. Toronto, Ontario, Canada. January 9, 2025. (Oral Presentation)
  8. Schmidt M. HIV Testing in Emergency Departments, The FAST-HIV Project and Provincial Expansion. OHTN Toronto To Zero Ambassador Table Meeting. Toronto, Ontario, Canada. October 24, 2024. (Oral Presentation)
  9. Hulme J, Schmidt M. HIV Testing in Emergency Departments, The FAST-HIV Project. Today’s Clinical Lab Digital Forum, Blood & Chemistry. Global Virtual Presentation. September 26, 2024. (Oral Presentation)
  10. Landes M, Hulme J, Bogoch I, Brinc D, Vose K, McKnight A, Mazzuli T. Closing the gap in access to HIV testing: Implementation and outcomes of a protocol for rapid HIV testing in the Emergency Department. Innovation Fund Showcase 2023. Toronto, Ontario, Canada. November 8, 2023. (Poster Presentation) https://ifpoc.org/2023tech8/
  11. Landes M, Hulme J. FAST-HIV: Feasible, Accessible, Standard Testing for HIV in the Emergency Department. DFCM City-Wide Research Rounds, University of Toronto. Virtual. September 21, 2023. (Oral Presentation)
  12. Lazor J, Kent-Rice J, Ginnocchio GF, Dell E, Klaiman M, Puchalski Ritchie LM, Garnett M, Landes M, Hulme J, McKnight A, Fremes E, Girdler H. Barriers and facilitators to the implementation of point of care testing for HIV in the emergency department: A mixed-methods study. Northern Health Research Conference (NHRC). Thunder Bay, Ontario, Canada. June 1-2, 2023 (Poster Presentation with recorded voice over by Janelle Lazor, medical student, NOSM)
  13. Kent-Rice, J, Lazor J, Ginocchio GF, Klaiman M, Dell E, Puchalski Ritchie LM, Landes M, Hulme J, Garnett M., Alsefaou A, Fremes E, Girdler H, McKnight  A. Barriers and facilitators to the implementation of point of care testing for HIV in the emergency department: A mixed-methods study. Canadian Association of Emergency Physicians (CAEP) Conference 2023. Toronto, Ontario, Canada. May 31, 2023. (Oral Presentation)
  14. Landes M, Hulme J, Garnett M, Vose K. HIV testing in the ED: Why testing matters to save lives. Canadian Association of Emergency Physicians (CAEP) Conference 2023. Toronto, Ontario, Canada. May 31, 2023. (Panel Presentation)
  15. Landes M, Hulme J, Bogoch I, Brinc D, Vose K, McKnight A, Mazzuli T. Closing the gap in access to HIV testing: Implementation and outcomes of a protocol for rapid HIV testing in the Emergency Department. Canadian Association of Emergency Physicians (CAEP) Conference 2023. May 29, 2023. (Poster Presentation)
  16. Landes M and Hulme J. Closing the gap in access to HIV testing:  Implementation and outcomes of a protocol for rapid HIV testing in the Emergency Department. Research Academic Day, Divisions of Emergency Medicine, University of Toronto. Toronto, Ontario, Canada. May 17, 2023. (Oral Presentation)
  17. Landes M. Why You Should Care About HIV in your ED. North York General Emergency Medicine Update. Toronto, Ontario, Canada. April 26, 2023. (Oral Presentation)
  18. Landes M. Dr. Megan Landes: Feasible, Accessible, Standard Testing for HIV in the ED. Prevention (PREV) Core session, CIHR Pan-Canadian Network for HIV and STBBI Clinical Trials Research. Virtual. October 2021 (Oral Presentation)
  19. Wiercigroch, D., Hulme, J., and Landes, M. Time for a national conversation: Practices and perspectives on HIV testing in Canadian emergency departments. Poster accepted to the Canadian Association of Emergency Physicians (CAEP) Conference 2020.

Funding

We are very grateful for the continued funding support for FAST-HIV from:

The Innovation Fund Provincial Oversight Committee