TY - JOUR
T1 - Evaluation of Rapid Testing Algorithms for Venue-based Anonymous HIV Testing among Non-HIV-Positive Men Who Have Sex with Men, National HIV Behavioral Surveillance (NHBS), 2017
AU - for the NHBS study group
AU - Whitby, Shamaya
AU - Smith, Amanda
AU - Rossetti, Rebecca
AU - Chapin-Bardales, Johanna
AU - Martin, Amy
AU - Wejnert, Cyprian
AU - Masciotra, Silvina
AU - Wortley, Pascale
AU - Todd, Jeff
AU - Melton, David
AU - Klevens, Monina
AU - Doherty, Rose
AU - O’Cleirigh, Conall
AU - Schuette, Stephanie Masiello
AU - Jimenez, Antonio D.
AU - Poe, Jonathon
AU - Vaaler, Margaret
AU - Deng, Jie
AU - Al-Tayyib, Alia
AU - Mattson, Melanie
AU - Griffin, Vivian
AU - Higgins, Emily
AU - Brandt, Mary Grace
AU - Khuwaja, Salma
AU - Lopez, Zaida
AU - Padgett, Paige
AU - Sey, Ekow Kwa
AU - Ma, Yingbo
AU - Spencer, Emma
AU - Nixon, Willie
AU - Forrest, David
AU - Anderson, Bridget
AU - Tate, Ashley
AU - Abrego, Meaghan
AU - Robinson, William T.
AU - Barak, Narquis
AU - Beckford, Jeremy M.
AU - Braunstein, Sarah
AU - Rivera, Alexis
AU - Carrillo, Sidney
AU - Bolden, Barbara
AU - Wogayehu, Afework
AU - Godette, Henry
AU - Brady, Kathleen A.
AU - Nnumolu, Chrysanthus
AU - Shinefeld, Jennifer
AU - Schafer, Sean
AU - Orellana, E. Roberto
AU - Bhattari, Amisha
AU - Raymond, H. Fisher
N1 - Funding Information:
This project was supported in part by an appointment to the Research Participation Program at the Centers for Disease Control and Prevention administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the U.S. Department of Energy and the Centers for Disease Control and Prevention.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - HIV rapid testing algorithms (RTAs) using any two orthogonal rapid tests (RTs) allow for on-site confirmation of infection. RTs vary in performance characteristics therefore the selection of RTs in an algorithm may affect identification of infection, particularly if acute. National HIV Behavioral Surveillance (NHBS) assessed RTAs among men who have sex with men recruited using anonymous venue-based sampling. Different algorithms were evaluated among participants who self-reported never having received a positive HIV test result prior to the interview. NHBS project areas performed sequential or parallel RTs using whole blood. Participants with at least one reactive RT were offered anonymous linkage to care and provided a dried blood spot (DBS) for testing at CDC. Discordant results (RT-1 reactive/RT-2 non-reactive) were tested at CDC with lab protocols modified for DBS. DBS were also tested for HIV-1 RNA (VL) and antiretroviral (ARV) drug levels. Of 6500 RTAs, 238 were RT-1 reactive; of those, 97.1% (231/238) had concordant results (RT-1/RT-2 reactive) and 2.9% (7/238) had discordant results. Five DBS associated with discordant results were available for confirmation at CDC. Four had non-reactive confirmatory test results that implied RT-1 false reactivity; one had ambiguous confirmatory test results which was non-reactive in further testing. Regardless of order and type of RT used, RTAs demonstrated high concordant results in the population surveyed. Additional laboratory testing on DBS following discordant results confirmed no infection. Implementing RTAs in the context of anonymous venue-based HIV testing could be an option when laboratory follow-up is not practicable.
AB - HIV rapid testing algorithms (RTAs) using any two orthogonal rapid tests (RTs) allow for on-site confirmation of infection. RTs vary in performance characteristics therefore the selection of RTs in an algorithm may affect identification of infection, particularly if acute. National HIV Behavioral Surveillance (NHBS) assessed RTAs among men who have sex with men recruited using anonymous venue-based sampling. Different algorithms were evaluated among participants who self-reported never having received a positive HIV test result prior to the interview. NHBS project areas performed sequential or parallel RTs using whole blood. Participants with at least one reactive RT were offered anonymous linkage to care and provided a dried blood spot (DBS) for testing at CDC. Discordant results (RT-1 reactive/RT-2 non-reactive) were tested at CDC with lab protocols modified for DBS. DBS were also tested for HIV-1 RNA (VL) and antiretroviral (ARV) drug levels. Of 6500 RTAs, 238 were RT-1 reactive; of those, 97.1% (231/238) had concordant results (RT-1/RT-2 reactive) and 2.9% (7/238) had discordant results. Five DBS associated with discordant results were available for confirmation at CDC. Four had non-reactive confirmatory test results that implied RT-1 false reactivity; one had ambiguous confirmatory test results which was non-reactive in further testing. Regardless of order and type of RT used, RTAs demonstrated high concordant results in the population surveyed. Additional laboratory testing on DBS following discordant results confirmed no infection. Implementing RTAs in the context of anonymous venue-based HIV testing could be an option when laboratory follow-up is not practicable.
KW - Discordant RT result
KW - False-reactivity
KW - HIV rapid testing
KW - HIV rapid tests algorithm
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U2 - 10.1007/s10900-020-00871-3
DO - 10.1007/s10900-020-00871-3
M3 - Article
C2 - 32651767
AN - SCOPUS:85087777015
VL - 45
SP - 1228
EP - 1235
JO - Journal of Community Health
JF - Journal of Community Health
SN - 0094-5145
IS - 6
ER -