Rapid HIV Testing Is Beginning to Make a Difference

Summary and Comment |
July 24, 2006

Rapid HIV Testing Is Beginning to Make a Difference

  1. Carlos del Rio, MD

Rapid tests could enable more HIV-infected people to know their serostatus and thus to receive early treatment and prevention services.

  1. Carlos del Rio, MD

Once HIV-infected people become aware of their HIV serostatus, they can receive treatment and take measures to prevent transmitting the virus. In 2003, the CDC launched an initiative to reduce the prevalence of undiagnosed HIV infection by expanding HIV testing, particularly through the use of rapid tests (ACC Jun 1 2003). As part of this initiative, the CDC purchased and distributed 790,310 OraQuick Advance Rapid HIV-1/2 Antibody Tests to 230 organizations in 37 states, the District of Columbia, Puerto Rico, and the Virgin Islands between September 2003 and December 2005.

Among the 372,960 tests administered for diagnostic purposes, results were preliminary positive in 5385 and subsequently confirmed as positive in 4650. Nearly 80% of all individuals with preliminary positive results received the results of confirmatory tests (whether positive, negative, or indeterminate). In telephone interviews, 48 program coordinators reported that the CDC initiative enabled their organizations to test more clients for HIV but that various challenges (including expired test kits, staff-training requirements, and additional regulations) had delayed implementation of testing.

Comment

OraQuick has excellent sensitivity and specificity. It is the only rapid HIV test using oral fluid to be CLIA-waived and thus usable in nonlaboratory settings. Furthermore, clients can obtain their test results in half an hour, then receive confirmatory testing and referral to care that same day. Unfortunately, the current report fails to mention how many of the 4650 HIV-infected individuals diagnosed through this program actually entered care or eventually received treatment, both of which are much more important outcomes than only receiving test results.

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