title: Introducing rapid oral-fluid HIV testing among high risk populations in Shandong, China: feasibility and challenges.
abstract: BACKGROUND
  This study was conducted to ascertain the feasibility of using rapid oral fluid testing as an alternative HIV testing method in China.
  
  
  METHODS
  This is a mixed-method study among men who have sex with men (MSM), female sex workers (FSW) and VCT clients, conducted in 4 cities in Shandong Province. A pre-tested questionnaire was administered to 1137 participants through face-to-face interview to assess demographic characteristics, HIV testing histories and willingness to accept rapid oral fluid testing. VCT clients were provided with the saliva test kits for a screening test and errors in operation were recorded. Testing results were compared between oral and blood testing. Short feedback questionnaire was administered to 200 FSW who had undergone oral testing.
  
  
  RESULTS
  The rate of willingness to take oral-fluid HIV testing among MSM, FSW and VCT clients was 72.8%, 72.1% and 67.4% respectively. Common errors recorded during test kit operation by the 229 VCT clients included: unpreparedness, wrong swab sampling, wrong dilution, wrong testing and inability to read test results. Advantages of oral testing listed by participants included: less intrusive, painlessness, easy self- testing and privacy. Disadvantages included perceived unreliable results (55.5%) and not nationally recognised (9%). Comparison of saliva and the blood testing results recorded a consistency rate of 0.970 (χ2 = 153.348, P < 0.001), implying an excellent consistency.
  
  
  CONCLUSIONS
  Introduction of oral rapid fluid testing as an alternative HIV testing method in China is highly feasible but with some challenges including low recognition and operation errors.
authors.forename: Gifty
authors.initials: G
authors.lastname: Marley
authors.forename: Dianmin
authors.initials: D
authors.lastname: Kang
authors.forename: Erin C
authors.initials: EC
authors.lastname: Wilson
authors.forename: Tao
authors.initials: T
authors.lastname: Huang
authors.forename: Yuesheng
authors.initials: Y
authors.lastname: Qian
authors.forename: Xiufang
authors.initials: X
authors.lastname: Li
authors.forename: Xiaorun
authors.initials: X
authors.lastname: Tao
authors.forename: Guoyong
authors.initials: G
authors.lastname: Wang
authors.forename: Huanmiao
authors.initials: H
authors.lastname: Xun
authors.affiliation: Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, #44 West Wenhua Road, Jinan 250012, Shandong Province, PR China. weima@sdu.edu.cn.
authors.forename: Wei
authors.initials: W
authors.lastname: Ma
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000378:metabolism*; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012463:Saliva / Q000378:metabolism*; D060386:Sex Workers / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D055815:Young Adult