RNA Testing VS. Rapid Testing
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MSM prefer less invasive HIV testing methods and trust lab-based tests more than rapid tests. The most preferred single test was RNA testing. Most MSM want consent obtained for HIV testing and pre-test counseling available. Limitations include testing information variation and non-representativeness of population already seeking testing. Integrating RNA testing and FDA-approved 4th generation rapid tests into programs may improve preferences. Consent and counseling should still be offered with testing.
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RNA Testing VS. Rapid Testing
- 1. RNA Testing VS. Rapid Testing Is it worth the wait? An Insight Into MSM Testing Preferences Joshua D. O’Neal Matthew R. Golden, MD, MPH Joanne D. Stekler, MD, MPH University of Washington Department of Medicine Public Health-Seattle & King County
- 2. Background OraQuick 2003 Neg Real Time Pooled RNA but EIA Pos Testing for MSM & Frozen Study OQ Pos
- 3. Background Specimen Collection Time Window Period
- 4. Background HIV Testing HIV Testing HIV Consent Counseling
- 5. Background
- 6. Methods
- 7. Methods Eligibility HIV Neg MSM or Transgender Seeking HIV Testing Not Tested in Last 3 Months Read & Speak English
- 8. Methods OraQuick Determine™* UniGold Oral Fluids & Fingerstick Ab + Ag Combo * Not Available for sale in the US
- 10. Methods Rapid • Testing Information Provided Tests • Method Preference • Test Trust Survey • ONE Test • Consent • Counseling Rapid Test Results
- 11. Results Test N = 902 Concordant Rapid 30 (3.3%) Positive Tests Discordant Rapid Tests 4 (0.4%) Among HIV Pos Rapid Neg / EIA Pos 1 (0.1%) Acute (EIA Neg / NAAT Pos) 5 (0.6%) Total HIV Pos 40 (4.4%)
- 12. HIV Testing: Trust VS. Specimen Collection Method 5 OQ_OralFluids OQ_FingerStick 4 UNIGOLD DETERMINE* ELISA Trust 3 RNA = STD Clinic (N=267) 2 = Gay City (N=223) 1 1 2 3 4 5 Specimen Collection Method * Not Available for sale in the US
- 13. If you could get only one HIV test today, which test would you get? Gay City N= 56 OQ Oral Fluids 9% 4% OQ Finger Stick 7% UNIGOLD 44% DETERMINE™* 24% ELISA 11% RNA 14% * Not Available for sale in the US
- 14. Should your doctor have to get your consent to test you for HIV Infection? N = 329 N = 223
- 15. Which pre-test counseling option would you prefer?
- 16. Summary • MSM prefer less invasive specimen collection methods • MSM trust lab based testing more than rapid HIV testing • RNA testing was the most preferred single test • MSM would like a provider to obtain consent for HIV testing • MSM want pre-test counseling available with HIV testing
- 17. Limitations • Testing information provided throughout testing session varied by location/counselor • Survey conducted after testing • Not all study participants surveyed (HIV+, time restrictions) • Representativeness: Population already seeking testing • 4th generation test not FDA approved
- 18. Discussion • Important to provide the most preferred types of testing • Consider integrating RNA testing into rapid testing programs • Once FDA approved, 4th generation rapid testing may become a more preferable testing option • Caution in separating both consent and counseling from HIV testing
- 19. Acknowledgments NIH R01 MH-86360 Study Participants Alere: Providing Determine™* Test Kits Public Health-Seattle & King County HIV/STD Program Gay City Health Project UW Primary Infection Clinic Bernard Branson Heather D. Baldwin * Not Available for sale in the US