Rapid HIV Testing in Urban Outreach: A Strategy for Improving Posttest Counseling Rates

Abstract

In 1998, 48% of persons who had HIV testing at publicly funded sites in the United States failed to return for test results and posttest counseling. Opportunities for timely HIV therapy were lost; valuable resources were wasted. This study tested the hypothesis that rapid HIV testing enables a high percentage of high-risk outreach clients to learn their serostatus. We did on-site counseling and rapid HIV testing at community-based organizations (e.g., chemical dependency programs, homeless shelters) in North Minneapolis. The project tested 735 persons. All but one (99.9%) learned their HIV serostatus. African Americans made up 79% of subjects. Rapid testing has a role to play in HIV outreach. It is useful in populations who are at high risk of HIV infection, who currently are not accessing HIV testing, and who have high failure to return rates. Future developments in rapid testing technology will make this testing option more convenient and cost-effective.

Implementing Rapid HIV Testing in Outreach and Community Settings: Results from an Advancing HIV Prevention Demonstration Project Conducted in Seven U.S. Cities

“…4 Implementing rapid HIV testing programs in outreach and community settings, and targeting minority groups and people at high risk for HIV infection hold promise as a way to identify people who have unrecognized HIV infection. Previous rapid testing programs in outreach settings-using either the laboratorybased Single Use Diagnostic System (SUDS) rapid test (Abbott-Murex, Norcross, Georgia) [6][7][8] or the point-ofcare OraQuick ® Rapid HIV-1 Antibody Test (OraSure Technologies, Bethlehem, Pennsylvania) 9,10 -have been successful in increasing the proportions of people who receive their preliminary HIV test results on the same day as their test. 7,9,10 The rate of acceptance of rapid HIV testing in outreach settings has varied from 14% to more than 70%, depending on the project and venue.…”

Rapid diagnostic HCV antibody assays

“…Of persons who consented to an HIV rapid test, 99% received their results and prevention counselling and >94% went to their first clinic appointment [26,32,33]. Since rapid HIV testing improves receipt of HIV test results [26][27][28]34], access to care and health outcomes [26,32,33], it follows that rapid anti-HCV assays can similarly benefit high-risk populations. Rapid, point-of-care testing for HCV can expedite and assist in the identification of those HCV-infected persons who are unaware of their infection, presenting new opportunities to provide prevention counselling messages and referrals for follow-up.…”

A review of Human Immunodeficiency Virus (HIV) rapid testing

“…Pant Pai (2013) (9) Overall acceptability: 74% to 96% for both supervised and unsupervised settings (7,35,(43)(44)(45)(46)(47)(48)(49) (10,54,69) Overall: 47% to 100% (all US studies) (20,54,55,65).…”