Thursday, May 19, 2022

Are Rapid Hiv Tests Accurate

What Is The Cost Of The Rapid Hiv Test

Is rapid HIV testing more accurate than ELISA? – Dr. Ramakrishna Prasad

The cost for the rapid HIV test, whether it uses oral fluid or a finger-stick blood sample is about $8 per test for public health officials and $8-$60 for other organizations. Most insurance plans now cover HIV testing.

There are several rapid tests available which can be done on either whole blood from a vein or finger stick, or oral fluids collected on a special swab. Many of these tests also can detect HIV-2, which is a different virus than HIV-1.

HIV-1 is the retrovirus that typically causes AIDS and is the HIV type most prevalent in most of the world, including the United States. If a person has antibodies to HIV-1, it means that he or she is infected with the HIV-1 virus that causes AIDS.

HIV-2 is a virus found primarily in western, sub-Saharan Africa. HIV-2 is rare in other parts of the world, but it has been reported sporadically in many locations. It is believed to be spread by the same methods of transmission as HIV-1. If a person has antibodies to HIV-2, it means that he or she is infected with the HIV-2 virus.

Testing for both HIV-1 and HIV-2 is important, particularly in people who may have acquired their infection in West Africa or from someone who may have links to that area. Much of the HIV testing currently done in the United States, including the rapid oral test, detects both HIV-1 and HIV-2 .

Available rapid tests include the following:

Third-Generation Tests

How Long Does It Take

The reason why the rapid HIV test is named as such is that it can provide results within 20 to 30 minutes. This means that a patient can return home soon after that. No other HIV tests can read results this fast, but the reliability of this procedure is not always satisfactory for medical conclusions to be made, which will be discussed below.

How The Oraquick In

What is the OraQuick In-Home HIV Test and how does it work?

The OraQuick In-Home HIV Test is a rapid self-administered over-the-counter test. The OraQuick In-Home HIV Test kit consists of a test stick to collect the specimen, a test tube to insert the test stick and complete the test, testing directions, two information booklets , a disposal bag and phone numbers for consumer support.

This approved test uses oral fluid to check for antibodies to HIV Type 1 and HIV Type 2, the viruses that cause AIDS. The kit is designed to allow you to take the HIV test anonymously and in private with the collection of an oral fluid sample by swabbing your upper and lower gums with the test device. After collecting the sample you insert the device into the kits vial which contains a developer solution, wait 20-40 minutes, and read the test result. A positive result with this test does not mean that an individual is definitely infected with HIV but rather that additional testing should be done in a medical setting to confirm the test result. Additionally, a negative test result does not mean that an individual is definitely not infected with HIV, particularly when exposure may have been within the previous three months. Again an individual should obtain a confirmatory test in a medical setting.

When should I take a test for HIV?

How reliable is the OraQuick In-Home HIV Test?

OraQuick In-Home HIV Test Fact Sheet

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Test Window And Accuracy

If you get a negative result, it’s important to remember that the test may not detect HIV up to three months after infection. You can only be sure you are truly HIV-negative if your most recent test was after the window period and you havent had a potential HIV exposure during the window period. If you have had a potential exposure, you will need to be retested.

What Are The Advantages Of A Rapid Hiv Test

Are Home Tests For Hiv Accurate

The rapid test allows for testing of more individuals. According to the CDC, 1.2 million Americans have HIV, but up to one in eight don’t know it. About 44,000 Americans per year become infected with HIV. This number has decreased recently due, in part, to more testing. Among those who get tested using traditional methods, 31% of those who test positive do not return for their results .

People give a variety of reasons for not returning for their test results. The frequency of each response depends on the population being tested. The most commonly given reasons include the following:

  • Fear of a positive result
  • Lack of transportation
  • Relocating to a new city
  • Belief that they are at low risk for HIV and therefore the result will be negative
  • Fear that their HIV status will be disclosed to someone else

Significant benefits of the rapid HIV test include the following:

Once important difference between the conventional laboratory test and rapid tests is the ability to detect very early or acute HIV infection. This is done with the addition of an HIV RNA PCR or NAT test. HIV RNA appears in the blood within the first few days of infection. If the antibody test is negative but the NAT is positive, this may indicate that the patient is very newly infected. NAT testing is also used to confirm a positive result of the third- or fourth-generation test. Western Blot testing is no longer routinely used.

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What Is Predictive Value

Predictive value is the calculated probability that a test result predicts whether a person is truly infected. This calculation produces a number that counselors can use in explaining HIV test results to their clients. For example, a higher predictive value means that a reactive test is more likely to indicate the person is truly infected.

Efficacy Of Rapid Testing

Further complicating the issue, some studies have revealed that certain types of rapid HIV tests are also producing false-negative results. A study conducted by the South African government revealed rapid HIV testing sensitivities that averaged 68.7% in Cape Towns local clinics. Thus, the tests are failing to detect HIV in nearly one third of patients who have the virus. In Cameroon, the same rapid testing algorithm that produces a specificity of 98.8% has a sensitivity of 94.7%, resulting in 6 out of every 100 people receiving a negative diagnosis when they are in fact HIV-positive. In the case of false negatives, the use of rapid testing to diagnose HIV during health fairs or screenings can actually do more harm than good by misleading an HIV-positive individual to believe that they are HIV-negative. False negatives are a threat not only to public health prevention strategy but also to the health and well being of the individual. A negative diagnosis, despite being incorrect in some cases, may prevent patients from seeking out other testing opportunities, taking the necessary precautions to prevent the transmission of HIV, and receiving the care and treatment that they need.

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What Does The Counselor Tell A Client Who Has A Reactive Rapid Hiv Test

One of the more challenging counseling issues is how to communicate reactive rapid HIV test results to clients without the benefit of a same-day confirmatory test result. Counselors should be able to discuss with the client the likelihood of whether the rapid HIV test result means the client has HIV infection. This discussion should be based on the prevalence of HIV among persons tested at that clinic coupled with an assessment of the client’s risk behaviors. In clinics that usually experience a high prevalence of HIV infection among their clients, a reactive rapid HIV test result is more likely to represent a true infection, especially in persons who report risk behaviors for HIV. Any person whose rapid HIV test is reactive should be counseled about the need to take precautions to prevent any possibility of transmitting HIV infection until their infection status has been determined by a confirmatory HIV test.

Should A Physician Prescribe Antiretroviral Treatment For A Pregnant Woman On The Basis Of Rapid Hiv Test Results

rapid hiv test accuracy 4 weeks (hiv antibody test, rapid hiv testing)

A negative rapid HIV test of course means that antiretroviral treatment is not necessary. Deciding what to do about therapy when the rapid HIV test is reactive is more complicated. If the circumstances are not urgent, it would be preferable to wait for the confirmatory test result. In other circumstances , physicians should base decisions about antiretroviral treatment on the predictive value of the preliminary rapid HIV test results and an assessment of the mother’s HIV risk. :1-31.)

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When Should I Do Such Testing

HIV can only be transmitted from an infected individual and only through direct transfer of body fluids. If any incident occurs, where you feel like youve been exposed to the body fluids of an infected person, then you should go for a rapid HIV test and post-test counseling right away.

However, its beneficial to conduct the procedure occasionally even when you are not suspicious, just as a regular check-up to see if you are free from the virus .

Whats Next If The Test Is Negative

If a person gets a negative test result and its been more than 3 months since they may have been exposed, they can be fairly certain that they do not have HIV.

If its been less than 3 months since exposure, they should consider taking another HIV test at the end of the 3-month period to be sure. During that time, its best that they use condoms during sex and avoid sharing needles.

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Sensitivity And Specificity Of Hiv Self

Our study suggests that a HIV oral-fluid self test has markedly better accuracy compared to a blood-based self-test in Singapore. In a previous study by our group, blood-based self-testing had a of 0.277. Out of 350 self-tests conducted, 197 were invalid in the prior study. In our current study, the value for inter-rater agreement comparing self-testing to healthcare worker testing was 0.97 . This suggests that, in Singapore, participants are much more able to perform oral fluid sample collection compared to finger-prick based sample collection.

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Study Shows That Some Tests Fall Short In Early Infection

As the United States aims to increase early diagnosis and treatment of people with HIV, a greater focus has been placed on determining the accuracy of HIV tests in real-world settingsnot only to minimize the number of false positive or negative test results but to better identify people during the early stages of infection when the risk of transmission is especially high.

In order to do this, researchers from the University of California, San Francisco conducted a review of over 21,000 HIV tests performed between the years 2003 and 2008 in some of the city’s high prevalence populations.

Of four types of tests used during this periodfrom first generation antibody tests to rapid oral tests761 people were diagnosed with HIV , while 58 were identified during acute infection.

The study also aimed to compare the accuracy of newer testing assaysincluding 4th generation antigen/antibody testsby retesting the blood from the 58 people previously diagnosed with acute HIV infection.

The accuracy was measured both in terms of sensitivity and specificity .

Test Type
87.3%

Window Periods Of Rapid Tests

The window period refers to the time after infection and before seroconversion, during which markers of infection are still absent or too scarce to be detectable. Tests cannot reliably detect HIV infection until after the window period has passed. All tests have a window period, which varies from test to test.

Delaney and colleagues estimated window periods for a handful of rapid tests in a 2017 study. However, all these estimates were based on testing blood plasma. In practice, tests are usually done on fingerprick blood and the window period is likely to be several days longer.

The fourth-generation Determine HIV-1/2 Ag/Ab Combo was estimated to have a median window period of 19 days . This indicates that half of all infections would be detected between 15 and 25 days after exposure. Ninety-nine per cent of HIV-infected individuals would be detectable within 43 days of exposure.

The third-generation INSTI HIV-1/HIV-2 test was estimated to have a median window period of 26 days . This indicates that half of all infections would be detected between 22 and 31 days after exposure. Ninety-nine per cent of HIV-infected individuals would be detectable within 50 days of exposure.

Basic information on testing

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What Is The Cost Of A Rapid Hiv Test

Prices may be different in different parts of the country. The SUDS test kit usually costs $6 to $10, which is more expensive than an EIA. However, the EIA requires expensive equipment and rapid HIV tests do not. Additional costs such as a laboratory or a laboratory technician’s time for conducting the tests should also be considered. Rapid HIV tests are simpler to perform and require fewer specialized skills than does an EIA.

Does A Negative Rapid Hiv Test Result Mean That A Person Has Nothing To Worry About

Rapid HIV Test Accuracy 90 Days After Exposure

Not necessarily. For most people who are tested, a negative HIV antibody test result does mean that they are not infected. However, in some cases a person may have been tested too soon . That is why it is important to assess specific risk behaviors during counseling, and discuss ways to change risky behaviors.

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Main Facts And Advantages Of A Rapid Hiv Test

Considering how dangerous and life-threatening HIV is, many techniques have been developed to check the presence of the virus in an individual.

Rapid HIV tests are used to screen people for the infection.

As the name suggests, this procedure can provide results quickly so that further measures can be planned without delay .

A rapid HIV test is performed much similar to a rapid plasma reagin test. Both collect either blood or saliva as a sample from the patient. Blood is collected with a syringe, while saliva is collected by rubbing a special medical swab on the subjects gums. The sample is then studied to detect the presence of HIV through medical procedures, and the results are conveyed to the patient. Sometimes a counseling session is due afterward.

Here are some of the advantages of taking a rapid test:

  • It quickly screens people for HIV.
  • The waiting time is reduced so people can know their results immediately and begin treatment without delay if required.
  • It is simple enough to be performed without advanced medical equipment. So, this procedure is readily available in many clinics, hospitals, and health centers.
  • It is suitable for people who are afraid of or uncomfortable with syringes.
  • Since rapid HIV tests can be performed quickly, they are useful in screening a larger number of people in a short time.
  • Although this procedure has a number of benefits, its accuracy is a matter of concern.

    How Accurate Is A Rapid Hiv Blood Test

    So, how accurate are these screenings? The results of rapid HIV tests are not 100% accurate. However, additional measures are often adopted to confirm the findings.

    If the results are positive, meaning HIV is detected in a subject, then the next step is to perform more advanced inquiries such as antigen and antibody tests or a nucleic acid amplification test . This also helps to avoid the cases of false-positive results of the rapid HIV test.

    If a subject is found to be HIV negative, they still cant be relieved. The results can be falsely negative, meaning the antibodies may not have been detected even when they are present.

    One of the various reasons that the test might provide negative results is when it is conducted during the window period of HIV. The window period is the time it takes for an infected person to produce a detectable amount of HIV antibodies after exposure to the virus.

    For the infection, this period can range from 2 to 4 weeks. If a subject is tested during this time, the results are bound to be negative. In such cases, they will be called for another test after a few weeks.

    When the results of rapid tests are combined with other advanced inquiry techniques, the final finding will be accurate.

    If the individual tests HIV-negative but is at a high risk of contracting the infection, PrEP treatment is administered. Read other articles on HIVPrEP to discover more about it.

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    What Is The Cost Of Rapid Hiv Test

    Its cost varies depending on the location, currency, and whether the procedure is performed in a small clinic or a well-established hospital. On average, the cost of this test will be around $40 to $70 , and will usually include pre-test and post-test counseling as well. However, most insurance plans should cover it, so check yours.

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