Repeat HIV testing of individuals with discrepant HIV self‑test results in Central Uganda

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Date
2019Author
Kisa, Rose
Matovu, Joseph K. B.
Buregyeya, Esther
Musoke, William
Vrana‑Diaz, Caroline J.
Korte, Jeffrey E.
Wanyenze, Rhoda K.
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Show full item recordAbstract
According to the user instructions from the manufacturer of OraQuick HIV self-test (HIVST) kits, individuals whose kits show one red band should be considered to be HIV-negative, no matter how weak the band is. However, recent reports show potential for a second false weak band after storage, thereby creating confusion in the interpretation of results. In this study, we re-tested individuals whose results were initially non-reactive but changed to weak reactive results to determine their true HIV status.
Methods: This study was nested within a large, cluster-randomized HIVST trial implemented among pregnant
women attending antenatal care and their male partners in central Uganda between July 2016 and February 2017.
Ninety-five initially HIV-negative respondents were enrolled into this study, including 52 whose kits developed a second
weak band while in storage and 43 whose kits were interpreted as HIV-positive by interviewers at the next followup
interview. Respondents were invited to return for repeat HIVST which was performed under the observation of a
trained nurse counsellor. After HIVST, respondents underwent blood-based rapid HIV testing as per the national HIV
testing algorithm (Determine (Abbot Laboratories), STAT-PAK (Chembio Diagnostic Systems Inc.) and Unigold (Trinity
Biotech plc.) and dry blood spots were obtained for DNA/PCR testing. DNA/PCR was considered as the gold-standard
HIV testing method.
Results: After repeat HIVST, 90 (94.7%) tested HIV-negative; 2 (2.1%) tested HIV-positive; and 3 (3.2%) had missing HIV
test results. When respondents were subjected to blood-based rapid HIV testing, 97.9% (93/95) tested HIV-negative
while 2.1% (2/95) tested HIV-positive. Finally, when the respondents were subjected to DNA/PCR, 99% (94/95) tested
HIV-negative while 1.1% (1/95) tested HIV-positive.
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- Medical and Health Sciences [3684]