Rapid HIV Testing of Clients of a Mobile STD/HIV Clinic

Abstract

HIV rapid testing may enhance the effectiveness of a mobile HIV/sexually transmitted disease (STD) screening clinic in at-risk populations who normally do not seek care. Our goal was to determine the usability and post-test counseling rates of rapid HIV testing services for clients tested on a mobile clinic. HIV Oraquick rapid HIV-1 testing (OraSure Technologies, Inc., Bethlehem, PA) (blood) was offered to clients seeking HIV/STI counseling and testing services from the street at predetermined locations in areas of high STD morbidity, drug use, and commercial sex work. Rapid test results were available on the same day at the van within 10 minutes. Disease intervention specialists (DIS) attempted to locate and counsel positive clients who did not stay for results. By comparison, when offered at the same time, 64.5% of clients preferred Oraquick to traditional serologic testing. The post-test counseling rate for clients tested for Oraquick was 89% for infected and 93% for uninfected. By comparison, 11% of infected clients and 40% of uninfected clients tested for traditional test were post-test counseled. Clients who tested for the traditional enzyme immunoassay (EIA) test were told to return to the van in 14 days for results and post-test counseling. In the adjusted model, we also found statistically significant differences comparing clients who choose Oraquick to traditional serologic tests. These data suggest that rapid HIV testing services may enhance the effectiveness of mobile STD/HIV clinics.

Sisters Empowered, Sisters Aware: Three Strategies to Recruit African American Women for HIV Testing

“…Overall the SESA Project was successful in providing HIV testing to a large number of African American women. Our overall findings were consistent with previous research suggesting that HIV testing should be made available and accessible to populations with reported risk behaviors through peer recruitment, mobile vans, and other recruitment strategies (Buchér et al, 2007;Grusky, Duan, Swanson, Woodbridge, & Leich, 2004;Liang et al, 2005;Vargo, Agronick, O'Donnell, & Steve, 2004;Worthington & Myers, 2002). Increasing access to HIV testing is an effective way to reach women early in the course of their infection and, if they test positive, to encourage them to seek medical care.…”

“…Targeted outreach is a strategy that uses outreach workers to target areas and locations where persons at high risk can be reached for HIV testing . Alternate venue is a strategy that offers HIV CTR in nontraditional settings (such as substance abuse treatment facilities, prisons, churches, and mobile units) to identify persons at high risk who normally would not seek HIV testing in clinical settings Clark, Bowles, Song, & Heffelfinger, 2008;Cohen et al, 2005;Liang et al, 2005). The social network strategy involves enlisting HIV-positive and high-risk HIV-negative persons to identify and refer persons in their sexual, social, or drug-using networks for HIV testing (Adimora & Schoenbach, 2005;CDC, 2005;Kimbrough et al, 2009).…”

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.…”

Implementation of Rapid HIV Testing Programs in Community and Outreach Settings: Perspectives from Staff at Eight Community-Based Organizations in Seven U.S. Cities

“…Studies have shown that offering HIV counseling and testing in community or outreach settings can be an effective strategy for identifying people with unrecognized HIV infection. [2][3][4][5][6][7] In the 50 states and territories that reported HIV testing data to the Centers for Disease Control and Prevention (CDC) in 2004, nearly 2% of people who were tested in outreach/field settings had positive test results. 3 Some studies of HIV testing among high-risk people in nonclinical or outreach settings have found even higher rates of HIV seroprevalence, ranging from 4% to 25%.…”

“…3 Some studies of HIV testing among high-risk people in nonclinical or outreach settings have found even higher rates of HIV seroprevalence, ranging from 4% to 25%. [4][5][6][7] Community-based organizations (CBOs) serve populations who are at high risk for HIV infection 8 and are well positioned to offer HIV counseling and testing services tailored to members of these high-risk groups. People at high risk for HIV infection often face barriers to accessing testing in traditional clinical settings, including a lack of transportation, reluctance to visit HIV or sexually transmitted disease (STD) clinics, or lack of access to clinics outside of regular business hours.…”