Abstract
BackgroundThis study was conducted to ascertain the feasibility of using rapid oral fluid testing as an alternative HIV testing method in China.MethodThis is a mixed-method study among men who have sex with men (MSM), female sex workers (FSW) and VCT clients, conducted in 4 cities in Shandong Province. A pre-tested questionnaire was administered to 1137 participants through face-to-face interview to assess demographic characteristics, HIV testing histories and willingness to accept rapid oral fluid testing. VCT clients were provided with the saliva test kits for a screening test and errors in operation were recorded. Testing results were compared between oral and blood testing. Short feedback questionnaire was administered to 200 FSW who had undergone oral testing.ResultsThe rate of willingness to take oral-fluid HIV testing among MSM, FSW and VCT clients was 72.8%, 72.1% and 67.4% respectively. Common errors recorded during test kit operation by the 229 VCT clients included: unpreparedness, wrong swab sampling, wrong dilution, wrong testing and inability to read test results. Advantages of oral testing listed by participants included: less intrusive, painlessness, easy self- testing and privacy. Disadvantages included perceived unreliable results (55.5%) and not nationally recognised (9%). Comparison of saliva and the blood testing results recorded a consistency rate of 0.970 (χ2 = 153.348, P < 0.001), implying an excellent consistency.ConclusionIntroduction of oral rapid fluid testing as an alternative HIV testing method in China is highly feasible but with some challenges including low recognition and operation errors.
Highlights
This study was conducted to ascertain the feasibility of using rapid oral fluid testing as an alternative HIV testing method in China
Common errors recorded during test kit operation by the 229 Voluntary counseling and testing (VCT) clients included: unpreparedness, wrong swab sampling, wrong dilution, wrong testing and inability to read test results
Design From July 2011 to December 2012, we conducted a mixedmethod study among 3 major high risk populations in 4 cities in Shandong Province, China, based on the Centre for Disease Control (CDC) implementation units for the province and the location of VCT centres
Summary
It is estimated that by the end of 2011, the number of people living with HIV in China was about 780,000 [1]. The National HIV/AIDs report showed that, men who have sex with men (MSM) and female sex workers FSW recorded a 5% and 6% (median) estimated prevalence respectively in 2009 which far exceeds the general populations’ prevalence of 0.05% [2,3]. Voluntary counseling and testing (VCT) has been an important tool employed by WHO and other health organizations worldwide to identify new cases and implement treatment as prevention strategies [10]. The imperative of scaling up HIV testing in China was recognized as an important strategy for identifying unknown positives and preventing onward transmission of HIV [11,12]. The biological, social, economic, political, and ethical concerns surrounding HIV surveillance, access to care and prevention still remains complex [1,2,13]
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