Diagnostic accuracy and acceptability of rapid HIV oral testing among adults attending an urban public health facility in Kampala, Uganda
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Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
PLoS ONE
Abstract
The prevalence of HIV in Uganda is 7.3%, and yet nearly 40% of people living with HIV are
unaware of their status. The current HIV testing policy which is strictly blood-based poses
several challenges including: a need for high level laboratory skills, stringent waste disposal
needs, and painful sample collection. It is envisaged that introduction of a rapid, painless
HIV oral fluid test as a potential alternative is likely to increase the number of people testing.
The aim of this study was to determine the diagnostic accuracy and acceptability of rapid
HIV oral testing among adults attending Kisenyi Health Centre IV in Kampala.
Methods and findings
We conducted a cross-sectional study among 440 adults recruited consecutively at Kisenyi
Health Centre IV from January to March 2016. The diagnostic accuracy of the HIV oral
test was assessed by comparing to the national HIV serial testing algorithm. We also
assessed for acceptability among patients and health care workers (HCWs) by triangulating
responses from a structured questionnaire, three focus group discussions and seven key
informant interviews. Acceptability was defined as willingness to take the test at the time of
the study and intention for future use of the test if it was availed.
The prevalence of HIV infection among study participants was 14.8%. The HIV oral fluid
test was highly accurate with sensitivity of 100% (95% CI; 94.5±100.0), specificity of 100%
(95% CI; 99.0±100.0), positive predictive value (PPV) of 100% (95% CI; 94.5±100.0) and
negative predictive value (NPV) of 100% (95% CI; 99.0±100.0). Acceptability of HIV oral testing was also high at 87.0% (95% CI; 83.6±89.9). Participants preferred HIV oral testing
because it was: pain free (91%, n = 399) and did not require blood draw (82%, n = 360).
Conclusion
The HIV oral fluid test has high diagnostic accuracy and acceptability. HIV oral testing is a
suitable addition to the national HIV testing strategies with the potential of increasing access
to HIV testing services in Uganda.
Description
Keywords
HIV oral testing, Adults, Urban public health, Kampala, Uganda
Citation
Nangendo J, Obuku EA, Kawooya I, Mukisa J, Nalutaaya A, Musewa A, et al. (2017) Diagnostic accuracy and acceptability of rapid HIV oral testing among adults attending an urban public health facility in Kampala, Uganda. PLoS ONE 12 (8): e0182050. https://doi.org/10.1371/journal. pone.0182050