Supervised Blood-Based Self-Sample Collection and Rapid Test Performance: A Valuable Alternative to the Use of Saliva by HIV Testing Programs With No Medical or Nursing Staff

Some saliva-based HIV testing initiatives, the authors wrote, "have resulted in an unacceptable percentage of false positives," while in many countries doctors or nurses are required for blood-based HIV testing programs. In the current study, the researchers evaluated whether -- following brief training, and with the supervision of a trained counselor -- "blood-based self-sample collection and rapid test performance could be a valuable alternative."

The study's participants were 208 Spanish-speaking attendees of a street-based HIV testing effort in Madrid. These individuals were tested twice -- once in the study, then again in the program -- using the same finger-stick, whole-blood rapid test: the Determine HIV-1/2 Ag/Ab Combo. Using previously adapted instructions, the counselor explained the correct procedure throughout the test. Under the guidance of the counselor, the participants then performed the test. A self-administered questionnaire was used to collect data on demographics and risk behavior. The study counselor read the results in the program and the study.

Of participants, 99.0 percent (95 percent confidence interval 96.6 percent to 99.9 percent) had a valid result in the study test -- the same percentage as in the program test administered by the doctor or nurse. In both the study and the program, two individuals had invalid test results; these were not the same persons.

"The study provides clear evidence that this methodology is a valuable alternative to saliva for HIV testing programs when medical or nursing staff required to take blood samples is not available," the authors concluded.

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