Performance of and preference for oral rapid HIV testing in The Bahamas

Initiatives to increase access to quality rapid HIV diagnostics have had relative success in the Caribbean in recent years, including use of oral rapid HIV testing. However, to date, there has not been any investigation into the performance or acceptability of oral fluids HIV testing in the region. In this cross-sectional study in The Bahamas, 252 persons of unknown serostatus were tested side-by-side with two oral rapid test brands, and the results were compared with the national fingerprick algorithm. In addition, an exit survey was administered to 234 study participants to assess user test preference. The most frequent survey response was to have no test preference (47.8%), but of those who expressed a test preference, most preferred oral (34.4%) versus fingerprick (17.8%) method. Both OraQuick and AWARE were 100% concordant with the gold standard. Therefore, our results show that oral fluids rapid testing is preferred over fingerprick testing by a subset of the potential target population and performs well in a population of undiagnosed persons attending screening clinic in The Bahamas.