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Updated: May 28, 2026
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Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
Published on: October 31, 2010
Use of a rapid HIV testing algorithm to improve linkage to care
Eugene G Martin1, Gratian Salaru, Sindy M Paul
1Department of Pathology and Laboratory Medicine, UMDNJ - Robert Wood Johnson Medical School, 1 World's Fair Drive, Suite 2200, Somerset, NJ 08873, USA. martineu@umdnj.edu
Summary
A new two-test rapid HIV testing algorithm (RTA) accurately identifies HIV, significantly improving linkage to care by reducing delays and eliminating the need for confirmatory Western blot testing.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Diagnostic Accuracy Studies
Background:
- Delayed diagnosis complicates HIV screening and referral pathways.
- Initial reactive rapid HIV tests often lead to patient attrition, hindering linkage to care.
Purpose of the Study:
- To assess the accuracy of a single-visit, two-test HIV rapid testing algorithm (RTA).
- To evaluate the RTA's impact on referring HIV-positive clients to care.
Main Methods:
- A two-test RTA was implemented across 24 sites in New Jersey.
- Rapid HIV test results were compared against Western blot (WB) for accuracy.
- Referral to care was based on two sequential positive rapid tests.
Main Results:
- The RTA screened 51,413 individuals, with 426 initial reactive results.
- 92.5% of initial reactive results were confirmed by a second rapid test.
- The RTA demonstrated 99.5% agreement with WB results, with 73.6% of RTA-positive clients referred to care.
Conclusions:
- The RTA significantly reduced false positive HIV results.
- Immediate referral based on RTA verification improves linkage to care.
- Western blot confirmation is unnecessary for effective HIV screening and can impede care linkage.
