BOSTON — A rapid HIV testing algorithm used in
publicly funded HIV counseling and testing sites decreased the proportion of
patients lost to follow-up and increased linkage to care, according to new
findings presented here.
“CDC is leading efforts to expand HIV testing in
the United States,” Kevin P. Delaney, MPH, of the division of
HIV/AIDS Prevention at the CDC, said during a presentation. “Two goals of
the National HIV/AIDS strategy are to increase the proportion of persons living
with HIV who are aware of their infection and to increase the proportion of
newly diagnosed HIV cases who receive medical care.”
Counselors across nine publicly funded HIV counseling
and testing sites in Los Angeles and San Francisco were trained to perform a
rapid HIV test, and if positive, immediately give a second rapid test and refer those individuals to HIV care.
A total of 17,701 people were tested between 2008 and
2009. Researchers then compared these results with 43,393 off-site confirmatory
testing results across 23 different rapid HIV testing sites.
The positive predictive value was 90% for a single rapid
HIV test compared with 100% for the rapid HIV testing algorithm. Only 47% of
patients with preliminary positive test results returned for their confirmatory
test results with the single rapid test, whereas all patients with positive
rapid HIV testing algorithm results received referral to care during the same
Moreover, those who received a referral were 67% more
likely to be in care within 90 days vs. those who received a preliminary
positive test result, but did not return for their confirmatory test results
and referrals (49%, P<.0001), according to Delaney.
“Had the rapid HIV testing algorithm been available
at all sites during the study, we estimate that an additional 162 HIV-positive
clients may have been able to be linked to care if they didn’t have the
opportunity to go away and not come back,” he said.
Delaney said the most important determinate of an
HIV-infected patient being engaged in medical care within 90 days of their
initial rapid test was receiving a referral for HIV care. “Using a second
rapid HIV test had the added benefit of distinguishing persons who were truly
infected from those with a false-positive test.” – by Ashley
For more information:
- Delany K. #132LB.Presented at: 18th Conference on Retroviruses and
Opportunistic Infections; Feb. 27-March 3, 2011; Boston.