title: HIV surveillance in a large, community-based study: results from the pilot study of Project Accept (HIV Prevention Trials Network 043).
abstract: BACKGROUND
  Project Accept is a community randomized, controlled trial to evaluate the efficacy of community mobilization, mobile testing, same-day results, and post-test support for the prevention of HIV infection in Thailand, Tanzania, Zimbabwe, and South Africa. We evaluated the accuracy of in-country HIV rapid testing and determined HIV prevalence in the Project Accept pilot study.
  
  
  METHODS
  Two HIV rapid tests were performed in parallel in local laboratories. If the first two rapid tests were discordant (one reactive, one non-reactive), a third HIV rapid test or enzyme immunoassay was performed. Samples were designated HIV NEG if the first two tests were non-reactive, HIV DISC if the first two tests were discordant, and HIV POS if the first two tests were reactive. Samples were re-analyzed in the United States using a panel of laboratory tests.
  
  
  RESULTS
  HIV infection status was correctly determined based on-in country testing for 2,236 (99.5%) of 2,247 participants [7 (0.37%) of 1,907 HIV NEG samples were HIV-positive; 2 (0.63%) of 317 HIV POS samples were HIV-negative; 2 (8.3%) of 24 HIV DISC samples were incorrectly identified as HIV-positive based on the in-country tie-breaker test]. HIV prevalence was: Thailand: 0.6%, Tanzania: 5.0%, Zimbabwe 14.7%, Soweto South Africa: 19.4%, Vulindlela, South Africa: 24.4%, (overall prevalence: 14.4%).
  
  
  CONCLUSIONS
  In-country testing based on two HIV rapid tests correctly identified the HIV infection status for 99.5% of study participants; most participants with discordant HIV rapid tests were not infected. HIV prevalence varied considerably across the study sites (range: 0.6% to 24.4%).
  
  
  BACKGROUND
  ClinicalTrials.gov registry number NCT00203749.
authors.affiliation: Dept. of Pathology, Johns Hopkins Univ, School of Medicine, Baltimore, MD, USA.
authors.forename: Estelle
authors.initials: E
authors.lastname: Piwowar-Manning
authors.forename: Agnes
authors.initials: A
authors.lastname: Fiamma
authors.forename: Oliver
authors.initials: O
authors.lastname: Laeyendecker
authors.forename: Michal
authors.initials: M
authors.lastname: Kulich
authors.forename: Deborah
authors.initials: D
authors.lastname: Donnell
authors.forename: Greg
authors.initials: G
authors.lastname: Szekeres
authors.forename: Laura
authors.initials: L
authors.lastname: Robins-Morris
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Mullis
authors.forename: Ana
authors.initials: A
authors.lastname: Vallari
authors.forename: John
authors.initials: J
authors.lastname: Hackett
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Mastro
authors.forename: Glenda
authors.initials: G
authors.lastname: Gray
authors.forename: Linda
authors.initials: L
authors.lastname: Richter
authors.forename: Michel W
authors.initials: MW
authors.lastname: Alexandre
authors.forename: Suwat
authors.initials: S
authors.lastname: Chariyalertsak
authors.forename: Alfred
authors.initials: A
authors.lastname: Chingono
authors.forename: Michael
authors.initials: M
authors.lastname: Sweat
authors.forename: Thomas
authors.initials: T
authors.lastname: Coates
authors.forename: Susan H
authors.initials: SH
authors.lastname: Eshleman
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa; D019411:Clinical Laboratory Techniques / Q000379:methods; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011159:Population Surveillance / Q000379:methods*; D013785:Thailand; D055815:Young Adult