15th Annual Conference of the British HIV Association 1-3 April 2009, Liverpool, UK

DOES POINT-OF-CARE TESTING IMPROVE ACCEPTANCE OF HIV TESTING?

HIV Med 2009 Apr 1-3 (Suppl 1);15:6 (abstract no. O7)

P Khan and S Creighton
Homerton University Hospital, London, UK

BACKGROUND: There is currently a drive to improve HIV detection rate in the UK. Internal audit at one inner city genito-urinary medicine clinic revealed that uptake of HIV testing to be 71%. Of those that tested positive for HIV, 10% failed to attend for follow-up. This study aims to assess whether the provision of point of care HIV testing (POCT) improves the uptake of HIV testing.

METHODS: Patients who declined serological testing or with high clinical risk of HIV infection were offered POCT by oral swab (Oraquick) or finger-prick (Insti) according to patient preference. Data were recorded prospectively on an electronic database and included demographic data, reason for POCT and result. External quality assurance was provided by random simultaneous POCT and serological testing of 1% of all POCT. Serological confirmation of all positive POCT was performed.

RESULTS: Nine hundred and fifty-one STI screens were performed between 01/12/08 and 31/12/08, of which 729 (77%) had an HIV test. 117/729 (16%) opted for POCT, of these 51 were Insti and 66 Oraquick. Main indications for POCT were requiring immediate result (92/117) and dislike of venepuncture (23/117). 3/51 (7%) Insti and 0 Oraquick tests yielded a positive result, compared to 4/611 (0.6%) of clients having conventional serology (P<0.0001). 2/51 Insti and 0 Oraquick tests were inconclusive due to technical difficulties with the kit. Staff felt offering POCT alongside routine GUM screening to be feasible.

CONCLUSIONS: Overall uptake of HIV testing increased by 6% with the introduction of POCT. POCT resulted in a significant increase in the number diagnosed with HIV infection. The availability of immediate result by POCT appears to be more acceptable to individuals who may be at high risk of HIV infection and reflects the policy of recommending POCT to these individuals. It is conceivable that immediate results may facilitate ongoing access to HIV care and further work will aim to assess this.

2009-04-01
O7

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