Quality of home-based rapid HIV testing by community lay counsellors in a rural district of South Africa

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dc.contributor.authorJackson, Debra
dc.contributor.authorNaik, Reshma
dc.contributor.authorDoherty, Tanya
dc.contributor.authorTabana, Hanani
dc.contributor.authorPillay, Mogiluxmi
dc.contributor.authorMadurai, Savathee
dc.contributor.authorZembe, Wanga
dc.date.accessioned2017-06-29T07:47:51Z
dc.date.available2017-06-29T07:47:51Z
dc.date.issued2013
dc.description.abstractINTRODUCTION: Lack of universal, annual testing for human immunodeficiency virus (HIV) in health facilities suggests that expansion of HIV testing and counselling (HTC) to non-clinical settings is critical to the achievement of national goals for prevention, care and treatment. Consideration should be given to the ability of lay counsellors to perform home-based HTC in community settings. METHODS: We implemented a community cluster randomized controlled trial of home-based HTC in Sisonke District, South Africa. Trained lay counsellors conducted door-to-door HIV testing using the same rapid tests used by the local health department at the time of the study (SD Bioline and Sensa). To monitor testing quality and counsellor skill, additional dry blood spots were taken and sent for laboratory-based enzyme-linked immunosorbent assay (ELISA) testing. Sensitivity and specificity were calculated using the laboratory result as the gold standard. RESULTS AND DISCUSSION: From 3986 samples, the counsellor and laboratory results matched in all but 23 cases. In 18 cases, the counsellor judged the result as indeterminate, whereas the laboratory judged 10 positive, eight negative and three indeterminate, indicating that the counsellor may have erred on the side of caution. Sensitivity was 98.0% (95% CI: 96.3 98.9%), and specificity 99.6% (95% CI: 99.4 99.7%), for the lay counsellor field-based rapid tests. Both measures are high, and the lower confidence bound for specificity meets the international standard for assessing HIV rapid tests. CONCLUSIONS: These findings indicate that adequately trained lay counsellors are capable of safely conducting high-quality rapid HIV tests and interpreting the results as per the kit guidelines. These findings are important given the likely expansion of community and home-based testing models and the shortage of clinically trained professional staff.en_US
dc.description.accreditationDepartment of HE and Training approved list
dc.identifier.citationJackson, D. et al. (2013). Quality of home-based rapid HIV testing by community lay counsellors in a rural district of South Africa. Journal of the International AIDS Society, 16 (18744): 1-4en_US
dc.identifier.issn1758-2652
dc.identifier.urihttp://hdl.handle.net/10566/3015
dc.language.isoenen_US
dc.publisherInternational Aids Societyen_US
dc.rightsCopyright Authors. This is an open access article under the terms of the Creative Commons Attribution-Non Commercial License.
dc.source.urihttp://dx.doi.org/ 10.7448/IAS.16.1.18744
dc.subjectHome-based HIV testing and counsellingen_US
dc.subjectSensitivityen_US
dc.subjectSpecificityen_US
dc.subjectRuralen_US
dc.subjectSouth Africaen_US
dc.subjectQuality assuranceen_US
dc.subjectRapid HIV testsen_US
dc.titleQuality of home-based rapid HIV testing by community lay counsellors in a rural district of South Africaen_US
dc.typeArticleen_US

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