Rapid HIV Tests – A Promising New Option

Health Service’s Centers for Disease Control and Prevention

(CDC) issued recommendations this Spring for the use of “rapid

HIV tests” in public health clinics. This new protocol will

allow clients to receive the results of their HIV tests within

5 to 30 minutes of their blood being drawn. Until now, HIV

testing always required at least two visits. The use of rapid

testing can greatly increase the number of people who learn

their HIV status, and offer quicker access to resources for

estimates that 25 million people are tested for HIV in the

United States each year. Two and one half million of these

tests are conducted in publicly funded testing and counseling

centers. However, in 1995, 25% of individuals testing positive

for HIV, and 33% of people testing HIV-negative at publicly

funded clinics did not return for their results after the

typical 14 day waiting period. Because rapid HIV testing makes

the test results available within a matter of minutes, the

Public Health Service hopes that this new option will allow

more people to become aware of their HIV status. If the rapid

test had been used in publicly funded clinics in 1995, the

CDC estimates that 697,495 more people would have learned

their HIV status. This represents what would have been an

increase of 29% for HIV positive individuals and 50% for HIV

negative individuals over the counseling and testing procedures

testing negative, a rapid testing procedure also offers an

opportunity for them to receive information and counseling

on risk reduction that they might have missed if a second

visit were required. For pregnant women, rapid testing could

provide timely information that would be helpful in making

decisions about preventive antiretroviral therapy or obstetric

procedures intended to minimize mother to infant transmission

of the virus. And for those who test positive with a rapid

test, in addition to getting immediate access to counseling

and treatment information, knowledge of their status might

prevent infections that would have possibly occurred while

SUDS (Single Use Diagnostic System for HIV-1) by Murex Corporation

is the only rapid HIV test licensed for use in the United

States. However, several different tests are being used in

other countries. With the CDC’s new recommendations on rapid

testing, others may soon become available in the U.S. The

SUDS test kit usually costs between $6-$15, which is more

expensive than the standard enzyme immunoassay (EIA) test.

that the cost of rapid HIV tests has been somewhat of a barrier

to more widespread implementation of this method. Duane Wilmot,

Coordinator of the Bell Flower STD Clinic in Marion County,

Indianapolis, says his organization cannot afford to offer

rapid HIV testing to everyone. As a result, rapid testing

is offered in the anonymous section of the clinic, but not

in the confidential setting. According to Wilmot, “We’d love

to be able to arrange to offer these tests in the confidential

clinic, but we just don’t have the money, space, or enough

lab technicians to do that yet.” He says that over 80% of

individuals coming in for anonymous HIV testing choose the

rapid method, despite the $15 fee. Not only are rapid tests

the preferred method, but Wilmot sees the greatest advantage

they have over the traditional EIA as being the fact that

the accuracy of rapid HIV testing, the CDC is confident that

SUDS is just as accurate as EIA. To ensure this high degree

of accuracy, the Public Health Service recommends that all

“reactive” rapid HIV tests be followed up by a second rapid

test, and then confirmed by another type of test, typically

the Western Blot method. At the Bell Flower clinic, out of

approximately 1500 rapid tests performed in the past year,

no false positive results were reported. All “reactive” tests

and others like him, are hopeful that the Public Health Service’s

endorsement will lead to more widespread use of rapid HIV

testing. With the CDC’s official set of recommendations comes

the likelihood that other manufacturers will see a promising

new market well worth the cost of getting FDA approval for

an HIV test. More tests could mean lower prices and ultimately

more people aware of their HIV status, and how to prevent

information on rapid HIV tests, contact the CDC’s National

AIDS Hotline 800/342-AIDS; or Murex Manufacturers 800/334-8570.

Centers for Disease Control and Prevention. (1998). Update:

HIV Counseling and Testing Using Rapid Tests – United States,

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for Disease Control and Prevention. (1998). Rapid HIV Tests:

F. & Kassler, W.J. (1996). Rapid Testing for HIV Antibody:

A Technology Whose Time Has Come. Annals of Internal