Supervised blood-based self-sample collection and rapid test performance: a valuable alternative to the use of saliva by HIV testing programmes with no medical or nursing staff.
OBJECTIVE
Some saliva-based HIV testing programmes have resulted in an unacceptable percentage of false positives. Many countries require blood-based testing programmes to have doctors/nurses. The authors evaluate whether, after brief training and under the supervision of a skilled counsellor, blood-based self-sample collection and rapid test performance could be a valuable alternative.


METHODS
208 Spanish-speaking attendees at a street-based HIV testing programme in Madrid participated in the study. Participants were tested twice, first in the study and then in the programme, using the same finger-stick whole-blood rapid test (Determine HIV-1/2 Ag/Ab Combo®). Based on previously adapted instructions, the study counsellor explained the procedure to follow throughout the test. Participants then performed the test under the guidance of the counsellor. Demographic and risk behaviour data were collected by a self-administered questionnaire. The test results in the programme and the study were read by the study counsellor.


RESULTS
99.0% (95% CI 96.6% to 99.9%) of participants had a valid result in the study test, the same percentage as in the programme test conducted by the doctor/nurse. Two persons had invalid test results in both the study and the programme, but they were not the same persons.


CONCLUSIONS
The study provides clear evidence that this methodology is a valuable alternative to saliva for HIV testing programmes when medical or nursing staff required to take blood samples is not available.
Escuela Nacional de Sanidad. Instituto de Salud Carlos III. C/Sinesio Delgado, 8. 28029 Madrid, Spain.
María J
MJ
Belza
M Elena
ME
Rosales-Statkus
Juan
J
Hoyos
Pilar
P
Segura
Eva
E
Ferreras
Rebeca
R
Sánchez
Gemma
G
Molist
Luis
L
de la Fuente
D000328:Adult; D001769:Blood / Q000821:virology; D001774:Blood Chemical Analysis; D019411:Clinical Laboratory Techniques / Q000379:methods*; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015488:HIV Antigens / Q000097:blood; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D007118:Immunoassay / Q000379:methods; D008297:Male; D016353:Self-Examination / Q000379:methods*; D013030:Spain; D013048:Specimen Handling / Q000379:methods*; D014773:Virology / Q000379:methods*
D015483:HIV Antibodies; D015488:HIV Antigens