Rapid HIV testing with same-day results: a field trial in Uganda

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Clinical Diagnostics

Background:

• Rapid, on-site HIV testing with same-day results can enhance service delivery in resource-limited settings.
• Increasing the proportion of clients who learn their serostatus is a key goal for HIV/AIDS programs.

Purpose of the Study:

• To validate the performance of the Capillus HIV-1/HIV-2 assay under field conditions.
• To assess the impact of rapid, on-site testing on the proportion of clients receiving their HIV serostatus results and counselling.

Main Methods:

• A field trial was conducted at AIDS Information Centre sites in Uganda.
• The Capillus HIV-1/HIV-2 assay was compared against the standard 2-EIA testing algorithm.
• Test performance metrics including sensitivity, specificity, and predictive values were calculated.

Main Results:

• The Capillus assay demonstrated high sensitivity (99.6%) and specificity (98.8%).
• Positive predictive value was 96.5% and negative predictive value was 99.9%.
• On-site testing led to a 27% increase in clients learning their HIV status and receiving counselling.

Conclusions:

• Simple, rapid HIV tests can be accurately performed on-site within a single clinic visit.
• Implementing rapid testing increases client engagement with HIV status disclosure and post-test counselling.
• This strategy is effective for improving HIV testing services in developing countries.