Rapid Whole-Blood Finger-Stick Test for HIV Antibody: Performance and Acceptability Among Women in Northern Thailand

Abstract

Although use of rapid HIV antibody tests of finger-stick blood specimens could expand voluntary counseling and testing in areas where fear of venipuncture and delays in learning test results are barriers, there is little information on performance and acceptability of these tests in Asia. We used the Hema. Strip HIV-1/2 test (Saliva Diagnostic Systems, Vancouver, WA) in a prospective cohort study of HIV seroincidence among women in northern Thailand from 1998 to 1999. Nurses obtained whole-blood specimens by finger-stick testing and provided test results and counseling at each visit. Acceptability of the rapid test was assessed at the first 6-month follow-up visit. HIV-1 seroprevalence among the 804 women screened at enrollment was 3.1%. Positive rapid test results from 25 women were confirmed by enzyme immunoassay and Western blot analysis using serum obtained by venipuncture. Of the 741 women who returned for follow-up, 56% preferred specimen collection by finger-stick testing to venipuncture, 80% preferred immediate rather than delayed test results, 79% preferred the rapid test method to typical testing methods, and 97% were satisfied with the test method used. Results from this study demonstrate the utility and acceptability of the rapid finger-stick test for HIV antibody among women in northern Thailand.

Challenges in the delivery of public HIV testing and counselling (HTC) in Douala, Cameroon: providers perspectives and implications on quality of HTC services

“…The results also showed that clients prefer attending the services where they can get their results without delay [57, 59–61]. This is consistent with the results of several studies reported that people who get tested preferred to receive their results on the test day [54, 59, 61]. …”

Should pregnant women with unknown HIV status be offered rapid HIV testing in labour?: Table 1

“…A study from Cambodia demonstrated that 95.4% and 99.4% of women in antenatal clinics and labour, respectively, accepted rapid HIV testing 30. In a study from Chiang Rai Province, Thailand, 96.8% of women in antenatal and postnatal settings were satisfied with the rapid testing process and 78.7% of women said they preferred this process to conventional HIV testing 36. Several studies examined factors associated with acceptability of rapid testing, and found an increased uptake of testing in pregnant women who were over 21 years of age, with a higher educational status, earlier gestational age (<32 weeks), and who had less antenatal care during pregnancy 20…”

Use of rapid HIV antibody testing for controlling the HIV pandemic

“…The number of false-positive determinations using HIV RTs has been surprisingly small even in low HIV prevalence populations where specificity would be expected to be reduced. International studies (USA, Peru, Thailand and India) have all shown HIV RTs specificities of 99.9% or greater in a population from antenatal clinics, sexually transmitted infection clinics and individuals having HIV occupational exposures [22][23][24][25][26][27]. The recent WHO report including ten HIV RTs tested on a wellcharacterized panel found specificities greater than 94.6% with four tests having 100% [28].…”

“…Although implementation and preferences for RTs and quick reporting are well documented at these venues [23,38,61,62], providing counselors to discuss both reactive and nonreactive results is still problematic in some places. Furthermore, there are reports that physicians sometimes would prefer a longer time before results were available so they have time to prepare to deliver the results to the patient.…”