title: Access and Quality of HIV-Related Point-of-Care Diagnostic Testing in Global Health Programs.
abstract: Access to point-of-care testing (POCT) improves patient care, especially in resource-limited settings where laboratory infrastructure is poor and the bulk of the population lives in rural settings. However, because of challenges in rolling out the technology and weak quality assurance measures, the promise of human immunodeficiency virus (HIV)-related POCT in resource-limited settings has not been fully exploited to improve patient care and impact public health. Because of these challenges, the Joint United Nations Programme on HIV/AIDS (UNAIDS), in partnership with other organizations, recently launched the Diagnostics Access Initiative. Expanding HIV programs, including the "test and treat" strategies and the newly established UNAIDS 90-90-90 targets, will require increased access to reliable and accurate POCT results. In this review, we examine various components that could improve access and uptake of quality-assured POC tests to ensure coverage and public health impact. These components include evaluation, policy, regulation, and innovative approaches to strengthen the quality of POCT.
authors.affiliation: International Laboratory Branch, Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Peter N
authors.initials: PN
authors.lastname: Fonjungo
authors.affiliation: International Laboratory Branch, Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Debrah I
authors.initials: DI
authors.lastname: Boeras
authors.affiliation: HIV Research Branch, US Centers for Disease Control and Prevention, Kisumu, Kenya.
authors.forename: Clement
authors.initials: C
authors.lastname: Zeh
authors.affiliation: International Laboratory Branch, Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Heather
authors.initials: H
authors.lastname: Alexander
authors.affiliation: International Laboratory Branch, Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Bharat S
authors.initials: BS
authors.lastname: Parekh
authors.affiliation: International Laboratory Branch, Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: John N
authors.initials: JN
authors.lastname: Nkengasong
mesh_terms: D003955:Diagnostic Tests, Routine / Q000379:methods*; D014943:Global Health; D015658:HIV Infections / Q000175:diagnosis*; D006297:Health Services Accessibility; D006801:Humans; D019095:Point-of-Care Systems; D014480:United Nations
keywords: access; evaluation; point-of-care testing; policy; quality assurance