Despite Food and Drug Administration approval of a 20-minute finger-prick HIV test nearly a year ago, fewer than a dozen California sites offer it. Health officials say strict state testing guidelines and confusion about how to implement the test have limited its introduction in California.

In several instances, officials are not advertising what sites are conducting the new test for fear of being overrun with patients. But the heart of the problem, state health officials say, is the fact that California has some of the most stringent regulatory testing guidelines in the country.

Federal regulations require that any site offering blood tests outside of traditional laboratory settings apply for a waiver. In addition, California requires test givers to have at least a high school diploma and go through more extensive training than the federal government requires.

Many of those expected to give the test are HIV counselors who often have little or no experience administering blood tests. Most of them have worked with tests that use an oral swab, and have not had to deal with many of these state and federal rules before.

"It's been a little confusing figuring out how this test fits in with our current system and all the rules that surround it," said Deanna Sykes, who has overseen implementation for California's Office of AIDS.

An 11-site pilot testing program scheduled for late May began in only four locations because many lacked measures guaranteeing the test's safety and accuracy, officials said. A recent Los Angeles proposal for 26 testing sites was held up for several weeks because state health officials were unsure a group application was technically valid. After checking with federal officials, the state decided it was all right; however, it could still be months before counselors are trained.

By processing waivers more quickly and offering training, state health officials hope there could be as many as 702 rapid testing sites statewide by next summer. The Legislature is also expected to consider a bill early next year that would condense some of the training into one session.

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