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Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Research article

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

Authors: Gifty Marley, Dianmin Kang, Erin C Wilson, Tao Huang, Yuesheng Qian, Xiufang Li, Xiaorun Tao, Guoyong Wang, Huanmiao Xun, Wei Ma

Published in: BMC Public Health | Issue 1/2014

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Abstract

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 (χ 2 = 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.
Literature
1.
go back to reference 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. 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.
go back to reference 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): e51919-10.1371/journal.pone.0051919.CrossRefPubMedPubMedCentral 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): e51919-10.1371/journal.pone.0051919.CrossRefPubMedPubMedCentral
3.
go back to reference 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. 10.1007/s10461-008-9446-5.CrossRefPubMed 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. 10.1007/s10461-008-9446-5.CrossRefPubMed
5.
go back to reference 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): e64652-10.1371/journal.pone.0064652.CrossRefPubMedPubMedCentral 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): e64652-10.1371/journal.pone.0064652.CrossRefPubMedPubMedCentral
6.
go back to reference 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. 10.1007/s10461-012-0225-y.CrossRefPubMed 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. 10.1007/s10461-012-0225-y.CrossRefPubMed
7.
go back to reference 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. 10.1007/s10461-011-9960-8.CrossRefPubMed 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. 10.1007/s10461-011-9960-8.CrossRefPubMed
8.
go back to reference 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. 10.1136/sextrans-2011-050295.CrossRefPubMed 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. 10.1136/sextrans-2011-050295.CrossRefPubMed
9.
go back to reference 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): e84950-10.1371/journal.pone.0084950.CrossRefPubMedPubMedCentral 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): e84950-10.1371/journal.pone.0084950.CrossRefPubMedPubMedCentral
12.
go back to reference 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.PubMed 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.PubMed
13.
go back to reference Merson MH: Early detection: the next steps. JAIDS. 2000, 25: S157-S159.PubMed Merson MH: Early detection: the next steps. JAIDS. 2000, 25: S157-S159.PubMed
14.
go back to reference 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. 10.1086/510747.CrossRefPubMed 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. 10.1086/510747.CrossRefPubMed
15.
go back to reference Rotheram-Borus MJ, Newman PA, Etzel MA: Effective detection of HIV. JAIDS. 2000, 25: 105-114. Rotheram-Borus MJ, Newman PA, Etzel MA: Effective detection of HIV. JAIDS. 2000, 25: 105-114.
16.
go back to reference Stover E, Steinberg L: Early detection of HIV: Implications for Prevention Research. JAIDS. 2000, 25: S93- Stover E, Steinberg L: Early detection of HIV: Implications for Prevention Research. JAIDS. 2000, 25: S93-
17.
go back to reference 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): e4445-10.1371/journal.pone.0004445.CrossRefPubMedPubMedCentral 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): e4445-10.1371/journal.pone.0004445.CrossRefPubMedPubMedCentral
18.
go back to reference Centers for Disease Control and Prevention: Advancing HIV prevention: new strategies for a changing epidemic, United States, 2003. MMWR. 2003, 52: 329-332. Centers for Disease Control and Prevention: Advancing HIV prevention: new strategies for a changing epidemic, United States, 2003. MMWR. 2003, 52: 329-332.
19.
go back to reference 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. 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.
go back to reference 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. 10.1111/j.1365-3156.2009.02304.x.CrossRefPubMed 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. 10.1111/j.1365-3156.2009.02304.x.CrossRefPubMed
21.
go back to reference Pant NP: Rapid oral fluid-based point-of-care HIV testing: applicability in developing countries. Pub Med. 2007, 126 (3): 171-173. Pant NP: Rapid oral fluid-based point-of-care HIV testing: applicability in developing countries. Pub Med. 2007, 126 (3): 171-173.
22.
go back to reference Pant NP, Klein MB: Are we ready for home-based HIV self-testing?. Future HIV Ther. 2008, 2 (6): 515-520. 10.2217/17469600.2.6.515.CrossRef Pant NP, Klein MB: Are we ready for home-based HIV self-testing?. Future HIV Ther. 2008, 2 (6): 515-520. 10.2217/17469600.2.6.515.CrossRef
23.
go back to reference Pant NP: Oral fluid-based rapid HIV Testing: issues, challenges and research directions. Expert Rev Mol Diagn. 2007, 7 (4): 325-328. 10.1586/14737159.7.4.325.CrossRef Pant NP: Oral fluid-based rapid HIV Testing: issues, challenges and research directions. Expert Rev Mol Diagn. 2007, 7 (4): 325-328. 10.1586/14737159.7.4.325.CrossRef
24.
go back to reference 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. 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.
go back to reference 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: e45168-10.1371/journal.pone.0045168.CrossRefPubMedPubMedCentral 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: e45168-10.1371/journal.pone.0045168.CrossRefPubMedPubMedCentral
26.
go back to reference 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.PubMed 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.PubMed
27.
go back to reference 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): e80594-10.1371/journal.pone.0080594.CrossRefPubMedPubMedCentral 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): e80594-10.1371/journal.pone.0080594.CrossRefPubMedPubMedCentral
29.
go back to reference 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): e185-10.1371/journal.pone.0000185.CrossRefPubMedPubMedCentral 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): e185-10.1371/journal.pone.0000185.CrossRefPubMedPubMedCentral
30.
go back to reference 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. 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.
Metadata
Title
Introducing rapid oral–fluid HIV testing among high risk populations in Shandong, China: feasibility and challenges
Authors
Gifty Marley
Dianmin Kang
Erin C Wilson
Tao Huang
Yuesheng Qian
Xiufang Li
Xiaorun Tao
Guoyong Wang
Huanmiao Xun
Wei Ma
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-422

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