rna testing vs. rapid testing
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RNA Testing VS. Rapid Testing
Is it worth the wait?
An Insight Into MSM Testing Preferences
Joshua D. O’NealMatthew R. Golden, MD, MPHJoanne D. Stekler, MD, MPH
University of Washington Department of MedicinePublic Health-Seattle & King County
Background
2003 Pooled RNA
for MSM
OraQuick Neg
but EIA Pos& Frozen OQ Pos
Real Time Testing Study
Background
Time
Window Period
Specimen Collection
Background
HIV Testing
HIV Counseling
HIV Testing Consent
Background
Methods
Methods
Eligibility
HIV Neg MSM or Transgender
Read & Speak English
Not Tested in Last 3 Months
Seeking HIV Testing
Methods
OraQuick Oral Fluids & Fingerstick UniGold Determine™*
Ab + Ag Combo
* Not Available for sale in the US
Methods
ELISA & RNA
MethodsRapid Tests
• Testing Information Provided
Survey
• Method Preference• Test Trust• ONE Test• Consent• Counseling
Rapid Test
Results
Results
Test N = 902
Concordant Rapid Positive Tests
30 (3.3%)
Discordant Rapid Tests Among HIV Pos
4 (0.4%)
Rapid Neg / EIA Pos 1 (0.1%)
Acute (EIA Neg / NAAT Pos) 5 (0.6%)
Total HIV Pos 40 (4.4%)
HIV Testing: Trust VS. Specimen Collection Method
1
2
3
4
5
1 2 3 4 5
Trus
t
Specimen Collection Method
OQ_OralFluidsOQ_FingerStickUNIGOLDDETERMINE*ELISARNA
= STD Clinic (N=267)
= Gay City (N=223)
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If you could get only one HIV test today, which test would you get?
14%
9% 4%
7%
24%
11%
44%
Gay CityN= 56 OQ Oral Fluids
OQ Finger Stick
DETERMINE™*
UNIGOLD
ELISA
RNA
* Not Available for sale in the US
Should your doctor have to get your consentto test you for HIV Infection?
N = 329
N = 223
Which pre-test counseling option would you prefer?
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
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
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
Acknowledgments
NIH R01 MH-86360Study ParticipantsAlere: Providing Determine™* Test KitsPublic Health-Seattle & King County HIV/STD ProgramGay City Health ProjectUW Primary Infection ClinicBernard BransonHeather D. Baldwin
* Not Available for sale in the US