ANONYMOUS HIV TESTING USING HOME COLLECTION AND TELEMEDICINE COUNSELING - A MULTICENTER EVALUATION

Background: Home human immunodeficiency virus (HIV) testing has been p roposed as an alternative to conventional HIV testing. Despite debate over HIV type 1 (HIV-1) home test systems, these concerns have not to our knowledge been previously studied. Objective: To evaluate the safe ty and efficacy of the Home Access Health Corp (Hoffman Estates, Ill) HIV-1 test system compared with traditional HIV-1 testing with venous blood. Methods: A total of 1255 subjects were studied prospectively in a blinded, subject-as-control evaluation at 9 outpatient clinics usin g intent-to-treat analysis. Subjects were provided a home collection k it (Home Access Health Corp) to collective their own finger-stick bloo d spot samples for laboratory analysis. Subjects received pretest coun seling by telephone and their comprehension was subsequently assessed. Subject-collected blood spot samples were compared with professionall y drawn blood spot samples for adequacy (sufficient for completing the Food and Drug Administration-endorsed testing) and with venous sample s for accuracy. Subjects called 3 days later for anonymous results and posttest counseling. Device safety was evaluated based on adverse eve nts incidence. Subject comprehension of HIV information was measured. Results: Subject-collected blood spot sample results were in complete agreement with venous blood sample results, demonstrating 100% sensiti vity and 100% specificity compared with venous controls. Ninety-eight percent of subjects obtained testable blood spot specimens compared wi th phlebotomists. Following pretest counseling, subjects answered 96% of HIV risk questions correctly. There were no significant adverse eve nts. Conclusion: Anonymous HIV-1 home collection kits with pretest and posttest telephone counseling can provide a safe and effective altern ative to conventional venous HIV-1 antibody testing.