title: Will patients "opt in" to perform their own rapid HIV test in the emergency department?
abstract: OBJECTIVE
  We evaluate the feasibility and accuracy of existing point-of-care HIV tests performed by an untrained patient compared with the routinely used HIV point-of-care test offered to patients in 2 urban emergency departments (EDs).
  
  
  METHODS
  From April 2008 through December 2009, patients who had completed a standard HIV oral fluid test performed by a trained health care professional and who were unaware of their results were recruited to perform a rapid point-of-care HIV test. Patients were given a choice of the oral fluid or the fingerstick blood point-of-care test. Evaluation of acceptability to perform the mechanics of the test was accessed by questionnaire. For the "self-test," the participant obtained his or her own sample and performed the test. The patient's results were compared with standard oral fluid results obtained by the health care professional.
  
  
  RESULTS
  Overall, 478 of 564 (85%) patients receiving a standard oral fluid HIV test volunteered, with a mean age of 38 to 39 years. Ninety-one percent of participants chose oral fluid and 9% chose blood (P<.05). Self-test results were 99.6% concordant with health care professionals' test results. For the self-testers, 94% of oral fluid testers and 84.4% of blood testers reported trusting the self-administered test result "very much." Furthermore, 95.6% of the oral fluid group and 93.3% of the blood group would "probably" or "definitely" perform a test at home, if available.
  
  
  CONCLUSIONS
  This study demonstrated that a significant proportion of patients offered a self-HIV point-of-care test volunteered and preferred using oral fluid. Patients' results agreed with standard HIV point-of-care results. The majority of participants trusted their results and would perform a point-of-care HIV test at home, given the opportunity.
authors.affiliation: Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD 21205, USA. cgaydos@jhmi.edu
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Gaydos
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Hsieh
authors.forename: Leah
authors.initials: L
authors.lastname: Harvey
authors.forename: Avanti
authors.initials: A
authors.lastname: Burah
authors.forename: Helen
authors.initials: H
authors.lastname: Won
authors.forename: Mary
authors.initials: M
authors.lastname: Jett-Goheen
authors.forename: Mathilda
authors.initials: M
authors.lastname: Barnes
authors.forename: Patricia
authors.initials: P
authors.lastname: Agreda
authors.forename: Nick
authors.initials: N
authors.lastname: Arora
authors.forename: Richard E
authors.initials: RE
authors.lastname: Rothman
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D015142:Baltimore / Q000453:epidemiology; D004636:Emergency Service, Hospital; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D019095:Point-of-Care Systems / Q000706:statistics & numerical data; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult