title: Home collection for frequent HIV testing: acceptability of oral fluids, dried blood spots and telephone results. HIV Early Detection Study Group.
abstract: OBJECTIVE
  To assess the feasibility and acceptability of bimonthly home oral fluid (OF) and dried blood spot (DBS) collection for HIV testing among high-risk individuals.
  
  
  METHODS
  A total of 241 participants [including men who have sex with men (MSM), injecting drug users (IDU), and women at heterosexual risk] were recruited from a randomly selected subset of study participants enrolled at four sites in the HIV Network for Prevention Trials (HIVNET) cohort, and assigned at random to bimonthly home collection of OF or DBS specimens over a 6 month interval. Participants could select telephone calls or clinic visits to receive HIV test results.
  
  
  METHODS
  Bimonthly specimens were tracked for adherence to the schedule, were evaluated for adequacy for testing, and tested using antibody assays and polymerase chain reaction (PCR) for DBS. The acceptability of bimonthly home OF and DBS collection and telephone counseling was assessed in an end-of-study questionnaire.
  
  
  RESULTS
  The laboratory received 96 and 90% of expected OF and DBS specimens, respectively; 99% of each specimen type was adequate for testing. Almost all (95%) participants chose results disclosure by telephone. The majority of participants (85%) reported that bimonthly testing did not make them worry more about HIV, and almost all (98%) judged that with bimonthly testing their risk behavior remained the same (77%) or became less risky (21%).
  
  
  CONCLUSIONS
  Bimonthly home specimen collection of both OF and DBS with telephone counseling is acceptable and feasible among study participants at high risk. These methods will be useful for the early detection of HIV infection and remote follow-up of research cohort participants in HIV vaccine and prevention trials.
authors.affiliation: Department of Family Medicine, University of Washington, Seattle, USA. freya@u.washington.edu
authors.forename: F
authors.initials: F
authors.lastname: Spielberg
authors.forename: C
authors.initials: C
authors.lastname: Critchlow
authors.forename: E
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: A S
authors.initials: AS
authors.lastname: Coletti
authors.forename: H
authors.initials: H
authors.lastname: Sheppard
authors.forename: K H
authors.initials: KH
authors.lastname: Mayer
authors.forename: D
authors.initials: D
authors.lastname: Metzgerg
authors.forename: F N
authors.initials: FN
authors.lastname: Judson
authors.forename: S
authors.initials: S
authors.lastname: Buchbinder
authors.forename: M
authors.initials: M
authors.lastname: Chesney
authors.forename: M
authors.initials: M
authors.lastname: Gross
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods / Q000706:statistics & numerical data*; D001801:Blood Stains; D015331:Cohort Studies; D003376:Counseling / Q000379:methods; D004279:DNA, Viral / Q000097:blood; D005260:Female; D015483:HIV Antibodies / Q000032:analysis / Q000097:blood; D006679:HIV Seropositivity / Q000175:diagnosis* / Q000453:epidemiology; D015497:HIV-1 / Q000235:genetics / Q000276:immunology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D011933:Reagent Kits, Diagnostic / Q000706:statistics & numerical data; D012307:Risk Factors; D012463:Saliva / Q000276:immunology; D012648:Self Care; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
chemical_list: D004279:DNA, Viral; D015483:HIV Antibodies; D011933:Reagent Kits, Diagnostic