Rapid HIV testing of clients of a mobile STD/HIV clinic

Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
AIDS PATIENT CARE and STDs (Impact Factor: 3.5). 05/2005; 19(4):253-7. DOI: 10.1089/apc.2005.19.253
Source: PubMed


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.

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    • "In a previous study, nearly half of individuals who received traditional blood-based tests, the results of which are not available until after several days, did not receive post-test counseling [29]. On the other hand, another study showed that the post-test counseling rate for participants who tested with the oral fluid rapid test was 89% for HIV-infected and 93% for uninfected participants [28]. "
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    ABSTRACT: Early detection of HIV infection enables timely care and treatment. However, many men who have sex with men (MSM) remain unaware of their HIV status because they do not or are unable to access HIV testing services. Oral fluid HIV rapid tests have the potential to increase HIV testing. This study is the first to evaluate willingness to use the oral fluid test among MSM in China. A cross-sectional study was conducted in Beijing from July to October, 2012. Data were collected by self-administered questionnaires. Of 262 who participated in the survey, 223(85.1%) reported that they were willing to use the oral fluid HIV rapid test. Willingness to use the oral fluid test was associated with higher education (adjusted odds ratio (AOR): 2.40, 95% confidence interval (CI): 1.13-5.10), lack of unprotected anal intercourse (UAI) with male partners in the past one month (AOR: 2.38; 95% 95%CI: 1.15-4.95), having taken more than 4 HIV tests (AOR: 3.54; 95%CI:1.52-8.28), and having ever heard of the oral fluid HIV rapid test from gay friends or gay organizations (AOR: 3.24, 95%CI: 1.40-7.51). Among those who expressed willingness to use the oral fluid HIV rapid test, the median amount of money they were willing to pay was 8 dollars. Among the 39 participants who were unwilling to use the oral fluid test, 79.5% (31/39) expressed concerns about the accuracy of the oral fluid HIV rapid test results and 17.9%(7/39) reported that they were not familiar with the oral fluid test and did not know how to use such a test. A high proportion of MSM in Beijing appear to be willing to use the oral fluid HIV rapid test. Appropriate cost and education measures could help improve acceptance of the oral fluid test.
    PLoS ONE 05/2013; 8(5):e64652. DOI:10.1371/journal.pone.0064652 · 3.23 Impact Factor
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    • "The benefits of HIV and STI testing outside of traditional health care settings has been well documented (e.g., Liang et al., 2005; Puro et al., 2004; Spielberg et al., 2005). Research comparing POC with standard HIV testing suggests that POC testing has resulted in increased HIV test uptake in outreach settings (Antonia-Gaddy et al., 2006; Wurcel, Zaman, Zhen, & Stone, 2005), in test volume (Greenwald, Hall, & Skolnik, 2006), as well as in receipt of results to 95% to 100% of study participants (Kendrick et al., 2005; Metcalf et al., 2005). "
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    ABSTRACT: Community research into women's experiences in the indoor commercial sex industry illustrated an urgent need for sexually transmitted infection (STI) and HIV education, prevention, testing, and treatment and culturally appropriate services to support the sexual and reproductive health of commercial sex workers (CSWs). This work also revealed that a high number of immigrant-primarily Asian-women are involved in the indoor sex industry. In response, the authors developed a community-academic research partnership to design and implement a blended outreach research program to provide STI and HIV prevention interventions for indoor CSWs and their clients. This Community Health Worker Model HIV Prevention and Health Promotion Program incorporated health education, primary care referrals, STI testing using self-swab techniques, and a point-of-care HIV screening test. Here the authors report on program implementation, design, and the experiences of participants and team members and provide research and vaccination recommendations for future work in this area. This work work affirms that community-based service providers can be a key entry point for indoor CSWs to access health care and sexual health promotion and education and may be a solution to missed opportunities to provide culturally and contextually appropriate education and services to this population.
    Health Promotion Practice 08/2012; DOI:10.1177/1524839912447189 · 0.55 Impact Factor
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    • "Using these field sites, NGOs could identify preliminary positive clients and then refer them to existing government ICTCs. In addition, oral testing allows patients to receive their preliminary results much faster than traditional techniques, significantly increasing the chances of completing follow-up (Liang et al., 2005). In this way, field-based HIV testing could reduce the timing and location based barriers to HIV testing that were reported by truck drivers during the 2007 conference (U.S. President's Emergency Plan for AIDS Relief, et al., 2007). "
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    ABSTRACT: In India, men who have sex with men (MSM) and truck drivers are high-risk groups that often do not access HIV testing due to stigma and high mobility. This study evaluated a field testing package (FTP) that identified HIV positive participants through video pre-test counseling, OraQuick oral fluid HIV testing, and telephonic post-test counseling and then connected them to government facilities. A total of 598 MSM and truck drivers participated in the FTP and completed surveys covering sociodemographics, HIV testing history, risk behaviors, and opinions on the FTP. MSM and truck drivers equally preferred video counseling, although MSM who had been previously tested preferred traditional methods. Nearly all participants preferred oral testing. Rates of counseling completion and linkage to government centers were low, with one-third of newly identified positives completing follow-up. With increased public-private coordination, this FTP could identify many hard-to-reach preliminary positive individuals and connect them to government testing and care.
    AIDS education and prevention: official publication of the International Society for AIDS Education 08/2012; 24(4):309-26. DOI:10.1521/aeap.2012.24.4.309 · 1.51 Impact Factor
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