Rapid HIV testing with same-day results: a field trial in Uganda

Abstract

Rapid, on-site HIV testing with same-day results may improve services and increase the number of clients who learn their serostatus in developing countries. To validate test performance under field conditions and assess the change in the proportion of clients who learn their serostatus, we conducted a field trial using the Capillus HIV-1/HIV-2 assay (Cambridge Diagnostics) at the AIDS Information Centre counselling and testing sites in Uganda. Compared to the standard 2-EIA testing algorithm, the sensitivity of Capillus was 99.6% (95% CI; 98.5%, 99.9%), the specificity was 98.8% (95% CI; 98.1%, 99.3%), the positive predictive value was 96.5% (95% CI; 94.5%, 97.8%), and the negative predictive value was 99.9% (95% CI; 99.5%, 100%). It took less than 5 min to perform a single test, and results were returned to clients in less than an hour, during which time clients were counselled. This resulted in a 27% increase in the proportion of clients who learned their serostatus and received counselling. We conclude that simple, rapid HIV tests can be performed accurately on-site within the time frame of a clinic visit, increasing the number of clients who learn their serostatus and receive post-test counselling.

Community-Based Rapid Oral Human Immunodeficiency Virus Testing for Tuberculosis Patients in Lima, Peru

“…[21][22][23]31 We identified HIV in 3% of our study cohort, compared with approximately 0.4% (Q1-Q3 = 0.3-0.5%) among adults 15 years of age nationwide. 45 This relatively high rate suggests that TB patients might represent an important HIV risk group in this region, and an easily targetable population for intensive HIV screening campaigns.…”

“…20 Rapid testing methods have also been shown to increase the number non-TB patients tested at point-of-care centers (e.g., as part of routine care, during urgent care or emergency department visits, and during labor) in resource-rich settings. 21,22 Community-based models have been shown to extend the reach of rapid testing by targeting at-risk (e.g., drug users, homosexual and bisexual populations, and/or commercial sex workers) and hard to access populations. [23][24][25] In a variety of resource-rich community settings, offering these services in mobile units has increased the rates of testing uptake among high-risk populations 26,27 and the percentage of people receiving results along with post-test counseling.…”

Evaluation of four rapid tests for diagnosis and differentiation of HIV-1 and HIV-2 infections in Guinea-Conakry, West Africa

“…However, use of the Genie II HIV1/HIV2 in Guinea-Conakry would be particularly compromised by the fact that the test requires sera (instead of whole blood) and is subject to cold chain availability, both of which are important operational considerations at peripheral facilities. [21][22][23][24] The First Response HIV Card Test 1-2.0 HIV test is also not recommended as it had a sensitivity that was below the WHO recommended minimum threshold of 99.5%.…”

Low-cost tools for diagnosing and monitoring HIV infection in low-resource settings

“…10 The use of these tests has substantially increased the volume of HIV tests performed and the number of patients who learnt their results before being lost to follow-up. 15 Also, since speedy testing is critical in prescribing intrapartum prophylactic therapy and antiretroviral drugs to prevent mother-to-child transmission, rapid HIV testing has had a positive effect on programmes to prevent HIV infection. 6,16 Fear of stigmatization from testing positive for HIV can deter at-risk individuals from seeking consultation 17 and can make people reluctant to disclose their HIV status.…”