Barriers to Implementation of Rapid and Point-of-Care Tests for Human Immunodeficiency Virus Infection

Abstract

Supplemental digital content is available in the text.

Health care workers’ perceptions of point-of-care testing in a low-income country—A qualitative study in Southwestern Uganda

“…Other inconveniences identified by this study have been described elsewhere, including difficulties in ensuring proper logistical processes, old infections being falsely signaled as active, inadequate training of end-users and insufficient knowledge of the use of POC tests, dubious quality of deployed tests, and test kits being unavailable when needed [ 27 , 29 – 32 ]. In some reports, these unappreciated aspects of POC testing have been described as barriers inhibiting successful implementation of POC tests into health systems of low- and middle-income countries [ 16 , 33 ], as well as in high-income countries [ 34 ]. The latter conceivably signal issues regarding design and manufacturing, that ought to be addressed by developers, as well as inadequate policies regarding the use of POC tests being common in low-, middle- and high-income countries.…”

“…Many participants demanded clear action plans, or clinical protocols, for the use of POC tests in patient management. These requests were not restricted to the sentiments of our participants, as they have been recognized by others and have been included in recommendations for POC test developers, policy makers, health providers and funders when seeking to integrate POC tests in health systems [ 16 , 33 , 37 ]. Other authors have suggested integrating the use of POC tests into existing protocols for patient management—such as the Integrated Management of Childhood Illness—in order to avoid some of the incorrect testing procedures described above [ 28 ].…”

Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives

“…Although current programmes could be enhanced by the introduction of POC testing [41,42] to address some existing challenges [43], it has been suggested [44,45] that certain factors need to be considered before POC implementation: Clinic flows, diagnostic accuracy, staff training, quality control, and turnaround times. In South Africa, multiple strategies [46] have previously been used to overcome high patient burden and staff shortages [7] with respect to rapid HIV testing.…”

The Gynecologic Health Consequences of Chlamydia trachomatis Infection in Military Servicewomen

“…A POC test is defined as a diagnostic modality that can provide accurate results and facilitate treatment within the same clinical visit as testing. 98 From both provider and patient perspectives, the acceptable turnaround time for STI POC test results is 20 minutes or less. 99 A POC diagnostic substantially reduces the healthcare costs associated with untreated CT infection, as evidenced by mathematical models demonstrating that a POC test with as low as 63% sensitivity ensures greater rates of treatment than standard testing with superior sensitivity but poor patient return rates.…”