Notification following new positive HIV test results

Abstract

Client notification of a new HIV diagnosis is critical for timely access to treatment and reduction in behaviours associated with HIV infection. It is also an important input in HIV transmission and disease progression models. We used national, Centers for Disease Control and Prevention-funded HIV testing events data collected through the National HIV Prevention Program Monitoring and Evaluation system to update estimates of the proportion of newly identified HIV-positives notified of their status. We compared estimates from 2008 to 2010 across test technologies, settings, and HIV risk groups. In 2010, notification following a positive rapid test was 99.6% compared with 99.3% in 2008. Notification following a positive conventional test was 81.5% in 2010 compared with 80.8% in 2008. To realise the full promise of early HIV diagnosis and treatment for the prevention of additional HIV cases, efforts to ensure prompt notification following a new HIV diagnosis will be crucial.

Cost-Effectiveness of Frequent HIV Testing of High-Risk Populations in the United States

“… 38 In the United States, the rapid antibody test currently surpasses conventional tests as a proportion of the 2.5 million tests annually funded by CDC due to its easier use outside the clinical setting. 17 The ability to provide rapid, point-of-care testing to people at higher risk than testing in a clinical setting may also improve cost-effectiveness ratios. The trade-off with rapid antibody testing, nearly 100% notification of results but lower test sensitivity, resulted in fewer averted transmissions compared with a fourth-generation test at the same testing frequencies.…”

“…We applied notification rates of 80% for conventional, fourth-generation testing and 99% for rapid point-of-care testing. 17 For acute infections, we assumed a 7-day time to receipt of results after a fourth-generation test and immediate results for rapid, point-of-care testing. We then estimated the number of HIV infections detected and duration of awareness of HIV diagnosis for each testing frequency.…”

The Perilous Road from HIV Diagnosis in the Hospital to Viral Suppression in the Outpatient Clinic

“…18,19 Receiving test results in the hospital likely hinges on a number of factors, including, but not limited to the following: the type of test used, frequency that tests are processed, and length of the hospital admission. As laboratories conform to CDC guidelines with uptake of fourth-generation HIV-1/2 Ag/Ab combination immunoassay screening tests and confirmation HIV-1/HIV-2 rapid antibody differentiation immunoassays, we would anticipate a decrease in the turnaround time for confirmation.…”

Costs and Consequences of Eliminating a Routine, Point-Of-Care HIV Screening Program in a High-Prevalence Jail

“…Intervention costs (C) included testing program costs: (1) HIV test kits, reagents, controls, and supply costs; (2) labor costs for testing and results notification; (3) administrative costs for program and data management; and (4) ART costs due to earlier detection (2 years) because of jail-based HIV testing. 15,17,18 Lifetime HIV treatment costs (T) were used to value HIV transmissions averted ($441,700). 16 Secondary HIV transmissions averted (T) for newly diagnosed, serostatus-aware people with HIV were estimated with the HIV Detection and Transmission Model.…”