Introducing rapid oral–fluid HIV testing among high risk populations in Shandong, China: feasibility and challenges

BMC Public Health

Wei Ma⁴  Huanmiao Xun⁴  Guoyong Wang²  Xiaorun Tao²  Xiufang Li³  Yuesheng Qian²  Tao Huang²  Erin C Wilson¹  Dianmin Kang²  Gifty Marley⁴ 

[1] San Francisco Department of Public Health, San Francisco, CA, USA;Shandong Provincial Center for Disease Control and Prevention, Jinan, China;The Sex Health Center, The Affiliated Hospital of Medical College Qingdao University, Qingdao, China;Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, #44 West Wenhua Road, Jinan 250012, Shandong Province, PR China

关键词: China;    Feasibility and acceptance;    Saliva testing;    Rapid oral fluid test;    HIV/AIDS;   

Others  :  1131460
DOI  :  10.1186/1471-2458-14-422

 received in 2014-01-12, accepted in 2014-04-25,  发布年份 2014

【 摘 要 】

Background

This study was conducted to ascertain the feasibility of using rapid oral fluid testing as an alternative HIV testing method in China.

Method

This 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.

Results

The 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.

Conclusion

Introduction 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.

【 授权许可】

   
2014 Marley et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Ministry of Health of People’s Republic of China: UNAIDS, WHO: epidemic estimation of AIDS in China, 2011. Chin J AIDS STD 2012, 18(1):1-5.
• [2]Zou H, Wu Z, Yu J, Li M, Ablimit M, Li F, Poundstone K: Internet-facilitated, Voluntary Counseling and Testing (VCT) clinic-based HIV testing among men who have sex with men in China. PLoS One 2013, 8(2):e51919.
• [3]Wang Y, Li B, Zheng J, Emrick CB, Cohen MS, Henderson GE: Factors related to female sex workers’ willingness to utilize VCT service: a qualitative study in Jinan City, Northern China. AIDS Behav 2009, 13(5):866-872.
• [4]Ministry of Health: Progress of AIDS Control in China. Available at: http://www.gov.cn/gzdt/2012-11/29/content_2278527.htm webcite. Accessed 2012 Dec 1
• [5]Xu Y, Zhang Z, Li D, Liu Y, Pan SW, Qi X, Wang B, Luo F, Xiao D, Shao Y, Ruan Y: Willingness to use the oral fluid HIV rapid test among men who have sex with men in Beijing, China. PLoS One 2013, 8(5):e64652.
• [6]Zou H, Hu N, Xin Q, Beck J: HIV testing among men who have sex with men in China: a systematic review and meta-analysis. AIDS Behav 2012, 16:1717-1728.
• [7]Hong Y, Zhang C, Li X, Fang X, Lin X, Zhou Y, Liu W: HIV testing behaviors among female sex workers in Southwest China. AIDS Behav 2012, 16:44-52.
• [8]Zhang Y, Chen P, Lu R, Liu L, Wu Y, Liu X, Zhao Z, Yi D: Prevalence of HIV among men who have sex with men in Chongqing, China, 2006–2009: cross-sectional biological and behavioural surveys. Sex Transm Infect 2012, 88:444-450.
• [9]Zhang L, Liang S, Lu W, Pan SW, Song B, Liu Q, Xu Y, Dong H, Xing H, Shao Y, Ruan Y: HIV, syphilis, and behavioral risk factors among female sex workers before and after implementation of harm reduction programs in a high drug-using area of China. PLoS One 2014, 9(1):e84950.
• [10]World Health organization: HIV testing and counselling. Available at: http://www.who.int/hiv/topics/vct/about/en/index.html webcite. Accessed 2013 October 22
• [11]China ministry of health and UN theme groups on HIV/AIDS: A joint assessment of HIV/AIDS prevention, treatment and care in China. Available at:http://data.unaids.org/UNA-docs/china_joint_assessment_2003_en.pdf webcite. Accessed 2013 October, 22
• [12]Summers T, Spielberg F, Collins C, Coates T: Voluntary counselling, testing, and referral for HIV: new technologies, research findings create dynamic opportunities. JAIDS 2000, 25:S128-S135.
• [13]Merson MH: Early detection: the next steps. JAIDS 2000, 25:S157-S159.
• [14]Stekler J, Maenza J, Stevens EC, Swenson PD, Coombs RW, Wood RW, Campbell MS, Nickle DC, Collier AC, Golden MR: Screening for acute HIV infection: lessons learned. Clin Infect Dis 2007, 44:459-461.
• [15]Rotheram-Borus MJ, Newman PA, Etzel MA: Effective detection of HIV. JAIDS 2000, 25:105-114.
• [16]Stover E, Steinberg L: Early detection of HIV: Implications for Prevention Research. JAIDS 2000, 25:S93.
• [17]Grigoryan A, Hall HI, Durant T, Wei X: Late HIV diagnosis and determinants of progression to AIDS or death after HIV diagnosis among injection drug users, 33 US States, 1996–2004. Plos One 2009, 4(2):e4445.
• [18]Centers for Disease Control and Prevention: Advancing HIV prevention: new strategies for a changing epidemic, United States, 2003. MMWR 2003, 52:329-332.
• [19]Hamers R, De Beer IH, Kaura H, Van Vugt M’L, Caparos L, de Wit TF R: Diagnostic accuracy of 2 oral fluid–based tests for HIV surveillance in Namibia. JAIDS 2008, 15:648-649.
• [20]Negin J, Wariero J, Mutuo P, Jan S, Pronyk P: Feasibility, acceptability and cost of home-based HIV testing in rural Kenya. Trop Med Int Health 2009, 14(8):849-855.
• [21]Pant NP: Rapid oral fluid-based point-of-care HIV testing: applicability in developing countries. Pub Med 2007, 126(3):171-173.
• [22]Pant NP, Klein MB: Are we ready for home-based HIV self-testing? Future HIV Ther 2008, 2(6):515-520.
• [23]Pant NP: Oral fluid-based rapid HIV Testing: issues, challenges and research directions. Expert Rev Mol Diagn 2007, 7(4):325-328.
• [24]Scott EL, Noble LD, Langeveldt M, Jentsch U, Venter WDF, Stevens W: Can oral fluid testing be used to replace blood-based HIV rapid testing to improve access to diagnosis in South Africa? JAIDS 2009, 15:646-648.
• [25]Ng OT, Chow AL, Lee VJ, Chen MC, Win MK, Tan HH, Chua A, Yee Sin Leo SY: Accuracy and user-acceptability of HIV self-testing using an oral fluid-based HIV rapid test. PLoS One 2012, 7:e45168.
• [26]Spielberg F, Branson BM, Goldbaum GM, Lockhart D, Kurth A, Celum CL, Rossini A, Critchlow CW, Wood RW: Overcoming barriers to HIV testing: preferences for new strategies among clients of a needle exchange, a sexually transmitted disease clinic, and sex venues for men who have sex with men. JAIDS 2003, 32:318-328.
• [27]Xun H, Kang D, Huang T, Qian Y, Li X, Wilson EC, Yang S, Jiang Z, Gong C, Tao X, Zhang X, Wang G, Song Y, Xu Z, Marley G, Huai P, Ma W: Factors associated with willingness to accept oral fluid HIV rapid testing among most-at-risk populations in China. Plos One 2013, 8(11):e80594.
• [28]China Food and Drug AdministrationAvailable at http://www.sfda.gov.cn webcite. Retrieved on 18th March, 2014
• [29]Jafa K, Patel P, MacKellar DA, Sullivan SP, Kevin P, Delaney KP, Tracy L, Sides TL, Alexandra P, Newman AP, Sindy M, Paul SM, Evan M, Cadoff EM, Eugene G, Martin EG, Patrick A, Keenan PA, Bernard M, Branson BM: Investigation of false positive results with an oral fluid rapid HIV-12 antibody test. PLoS One 2007, 2(1):e185.
• [30]Lang B, Bing-Jun L: Present situation and progress in research on HIV/AIDS laboratory testing. Chin J Evid-based Med 2008, 8(3):206-209.