title: Expansion of HIV screening to non-clinical venues is aided by the use of dried blood spots for Western blot confirmation.
abstract: BACKGROUND
  HIV rapid testing programs in New York State (NYS) are required to collect a specimen for confirmation of a preliminary positive result; however, some venues have limited capacity to collect venous blood, and confirmation using oral fluid is restricted by cost and availability.
  
  
  OBJECTIVE
  To evaluate the feasibility of using dried blood spots (DBS) at non-clinical HIV rapid testing sites for Western blot testing.
  
  
  METHODS
  The New York State Department of Health facilitated registration of 48 non-clinical HIV test sites and provided training on DBS procedures. Following a reactive rapid test, DBS were collected by fingerstick onto filter paper cards, dried and mailed to the NYS public health laboratory for Western blot testing.
  
  
  RESULTS
  From October 2010 to December 2012, 280 DBS specimens were submitted for confirmation. Four (1.4%) were unsatisfactory for testing and 276 (98.6%) DBS were tested. Of these, 235 (85.1%) were positive, 37 (13.4%) were negative and 4 (1.4%) were indeterminate. During this period, the laboratory also received 1033 venous blood specimens for rapid test confirmation, and 35 (3.4%) were unsatisfactory. Of the 998 tested by Western blot, 784 (78.6%) were positive, 197 (19.7%) were negative and 17 (1.7%) were indeterminate.
  
  
  CONCLUSIONS
  Compared to venous blood, the percentage of rapid test referral specimens with a positive Western blot was significantly greater for DBS specimens and the frequency of unsatisfactory specimens did not differ significantly. These results indicate that DBS are a suitable alternative to venous blood for confirmation of HIV rapid tests conducted at non-clinical sites.
authors.affiliation: Bloodborne Viruses Laboratory, Wadsworth Center, New York State Department of Health, Albany, NY 12201, United States.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Sullivan
authors.affiliation: Bureau of HIV and STD Field Services, AIDS Institute, New York State Department of Health, Albany, NY 12201, United States.
authors.forename: Mara San
authors.initials: MS
authors.lastname: Antonio-Gaddy
authors.affiliation: Bureau of HIV and STD Field Services, AIDS Institute, New York State Department of Health, Albany, NY 12201, United States.
authors.forename: April
authors.initials: A
authors.lastname: Richardson-Moore
authors.affiliation: Bloodborne Viruses Laboratory, Wadsworth Center, New York State Department of Health, Albany, NY 12201, United States; Department of Biomedical Sciences, School of Public Health, University at Albany, Albany, NY 12201, United States.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Styer
authors.affiliation: Bureau of HIV and STD Field Services, AIDS Institute, New York State Department of Health, Albany, NY 12201, United States.
authors.forename: Deborah
authors.initials: D
authors.lastname: Bigelow-Saulsbery
authors.affiliation: Bloodborne Viruses Laboratory, Wadsworth Center, New York State Department of Health, Albany, NY 12201, United States. Electronic address: mmp09@health.state.ny.us.
authors.forename: Monica M
authors.initials: MM
authors.lastname: Parker
mesh_terms: D000956:Antigens, Viral / Q000097:blood*; D015153:Blotting, Western / Q000379:methods*; D019411:Clinical Laboratory Techniques / Q000379:methods*; D003890:Desiccation; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D009518:New York; D013048:Specimen Handling / Q000379:methods*
chemical_list: D000956:Antigens, Viral
keywords: Confirmation; Dried blood spot; HIV; Rapid testing; Western blot