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.

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

9. Methods
ELISA & RNA

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