OPTIMIZING THE DELIVERY OF HIV COUNSELING AND TESTING SERVICES - THE UGANDA EXPERIENCE USING RAPID HIV ANTIBODY-TEST ALGORITHMS

The AIDS Information Center (AIC) was established in Kampala, Uganda i n 1990 in response to increasing interest by members of the general pu blic who wished to know their HIV serostatus. By 1996, >300,000 client s had been seen. HIV serologic testing was performed at a central labo ratory and results reported back to AIC after 2 weeks. Approximately 2 5% of clients failed to learn their HIV serostatus as a result of fail ure to return or late arrival of results. To address these issues, AIC carried out an evaluation of 3 rapid HIV assays, Sere-Strip, SeroCard : and Capillus, against a standard criterion to identify a testing alg orithm that could be used as an on-site confirmatory testing strategy, The study was carried out over a period of 5 working days and 325 cli ents were seen. An algorithm was identified, which gave no indetermina te results with unambiguously positive or negative specimens, which wa s 100% sensitive and specific, and which could be integrated with mini mal disruption into existing counseling procedures. All clients left A IC knowing their HIV serostatus and having spent <2 hours at the Cente r. The results of this evaluation demonstrate that ''same-day'' result s can be provided in counseling and testing settings without compromis ing the quality of counseling or the accuracy of HIV testing.