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HIV rapid diagnostic testing by lay providers in a key population-led health service programme in Thailand

Author List
Rapeeporn Wongkanya
Tippawan Pankam
Shauna Wolf
Supanit Pattanachaiwit
Jureeporn Jantarapakde
Supabhorn Pengnongyang
Prasopsuk Thapwong
Apichat Udomjirasirichot
Yutthana Churattanakraisri
Nanthika Praweperay
Apiluk Paksornsit
Thidadaow Sitthipau
Sarayut Petchaithong
Raruay Jitsakulchaidejt
Somboon Nookhai
Cheewanan Lerpiriyasuwaty
Sumet Ongwandee
Praphan Phanuphak
Nittaya Phanuphak

Abstract

Introduction: Rapid diagnostic testing (RDT) for HIV has a quick turn-around time, which increases the proportion of people testing who receive their result. HIV RDT in Thailand has traditionally been performed only by medical technologists (MTs), which is a barrier to its being scaled up. We evaluated the performance of HIV RDT conducted by trained lay providers who were members of, or worked closely with, a group of men who have sex with men (MSM) and with transgender women (TG) communities, and compared it to tests conducted by MTs. Methods: Lay providers received a 3-day intensive training course on how to perform a finger-prick blood collection and an HIV RDT as part of the Key Population-led Health Services (KPLHS) programme among MSM and TG. All the samples were tested by lay providers using Alere Determine HIV 1/2. HIV-reactive samples were confirmed by DoubleCheckGold Ultra HIV 1&2 and SD Bioline HIV 1/2. All HIV-positive and 10% of HIV-negative samples were re-tested by MTs using Serodia HIV 1/2. Results: Of 1680 finger-prick blood samples collected and tested using HIV RDT by lay providers in six drop-in centres in Bangkok, Chiang Mai, Chonburi and Songkhla, 252 (15%) were HIV-positive. MTs re-tested these HIV-positive samples and 143 randomly selected HIV-negative samples with 100% concordant test results. Conclusion: Lay providers in Thailand can be trained and empowered to perform HIV RDT as they were found to achieve comparable results in sample testing with MTs. Based on the task-shifting concept, this rapid HIV testing performed by lay providers as part of the KPLHS programme has great potential to enhance HIV prevention and treatment programmes among key at-risk populations.

Article Category

HIV cure research

Article Type

Original research

Posted Date

22-12-2017

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