title: The rise of targeted HIV oral rapid testing in Australia.
abstract: OBJECTIVE
  To assess the performance and acceptability of the OraQuick Advance Rapid HIV-1/2 Antibody Test (ORT) in Australia.
  
  
  METHODS
  Cross-sectional study of 1074 men who have sex with men (MSM) and individuals aged 18 years or older at high risk of acquiring HIV infection who attended five public HIV or sexual health services, two general practices and one community clinic in Sydney from 1 January to 31 December 2013.
  
  
  METHODS
  One ORT confirmed by fourth-generation HIV enzyme immunoassay (EIA).
  
  
  METHODS
  ORT sensitivity and specificity compared with EIA; acceptabiity of the ORT to participants.
  
  
  RESULTS
  83.5% of participants were MSM, 90.3% were aged under 50 years, and 9% had never been tested for HIV. There were 11 true-positive ORT results, two false-negative (non-reactive) results (both were early infections), and one false-positive (reactive) result (due to reader error). Sensitivity and specificity were 84.6% and 99.8%, respectively (compared with a sensitivity of 99.3% and specificity of 99.8% listed by the manufacturer). Three quarters of participants (74.0%; 730/987) found the ORT less stressful than venous sampling. Those who usually had tests at intervals of greater than 3 months deemed the ORT less stressful than those who had quarterly tests (77.5% v 64.8%; P<0.001). Nearly all participants (99.2%; 998/1006) would have an ORT again and 99.4% (994/1000) would recommend it to peers. Most participants (69.1%; 720/1042) felt ORT approval by Australia's Therapeutic Goods Administration (TGA) would encourage testing.
  
  
  CONCLUSIONS
  ORT sensitivity is reduced in early HIV infection. The test is highly acceptable and less stressful than venous sampling. Participants are keen to be tested with the ORT in future, would recommend it to peers and would have tests more frequently if the ORT were licensed. TGA approval of this test might slow increasing HIV infection rates among MSM and others by facilitating diagnosis and treatment.
authors.affiliation: Albion Centre, South Eastern Sydney Local Health District, Sydney, NSW, Australia. derek.chan2@sesiahs.health.nsw.gov.au.
authors.forename: Derek
authors.initials: D
authors.lastname: Chan
authors.affiliation: Albion Centre, South Eastern Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Stewart
authors.affiliation: Albion Centre, South Eastern Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: Maggie
authors.initials: M
authors.lastname: Smith
authors.affiliation: Albion Centre, South Eastern Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: Tony
authors.initials: T
authors.lastname: Price
authors.affiliation: Short Street Clinic, Sydney, NSW, Australia.
authors.forename: Jo
authors.initials: J
authors.lastname: Lusk
authors.affiliation: Western Sydney Sexual Health Centre, Sydney, NSW, Australia.
authors.forename: Catriona
authors.initials: C
authors.lastname: Ooi
authors.affiliation: Kirketon Road Centre, Sydney, NSW, Australia.
authors.forename: Phillip
authors.initials: P
authors.lastname: Read
authors.affiliation: Taylor Square Private Clinic, Sydney, NSW, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Finlayson
mesh_terms: D000328:Adult; D001315:Australia; D003430:Cross-Sectional Studies; D015483:HIV Antibodies / Q000378:metabolism; D015658:HIV Infections / Q000175:diagnosis* / Q000523:psychology; D018451:Homosexuality, Male; D006801:Humans; D007159:Immunologic Tests / Q000379:methods* / Q000523:psychology; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000523:psychology; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D012463:Saliva; D012680:Sensitivity and Specificity; D013315:Stress, Psychological / Q000209:etiology
chemical_list: D015483:HIV Antibodies