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Optimizing the Delivery of HIV Counseling and Testing Services: The Uganda Experience Using Rapid HIV Antibody Test Algorithms

Downing Robert G.; Otten, Ron A.; Marum, Elizabeth; Biryahwaho, Benon; Alwano-Edyegu, Mary Grace; Sempala, Sylvester D. K.; Fridlund, Carol A.; Dondero, Timothy J.; Campbell, Carl; Rayfield, Mark A.
JAIDS Journal of Acquired Immune Deficiency Syndromes: August 1st, 1998

The AIDS Information Center (AIC) was established in Kampala, Uganda in 1990 in response to increasing interest by members of the general public who wished to know their HIV serostatus. By 1996, >300,000 clients had been seen. HIV serologic testing was performed at a central laboratory and results reported back to AIC after 2 weeks. Approximately 25% of clients failed to learn their HIV serostatus as a result of failure to return or late arrival of results. To address these issues, AIC carried out an evaluation of 3 rapid HIV assays, Sero-Strip, SeroCard, and Capillus, against a standard criterion to identify a testing algorithm 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 clients were seen. An algorithm was identified, which gave no indeterminate results with unambiguously positive or negative specimens, which was 100% sensitive and specific, and which could be integrated with minimal disruption into existing counseling procedures. All clients left AIC knowing their HIV serostatus and having spent <2 hours at the Center. The results of this evaluation demonstrate that “same-day” results can be provided in counseling and testing settings without compromising the quality of counseling or the accuracy of HIV testing.

Address correspondence and reprint requests to Robert G. Downing, CDC/UVRI Research Collaboration, Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda; email:

Use of trade names is for identification only and does not constitute endorsement by the U.S. Public Health Service, the U.S. Department of Health and Human Services, the U.S. Centers for Disease Control and Prevention, or the Ministry of Health, Uganda.

Manuscript received October 25, 1997; accepted March 16, 1998.

© Lippincott-Raven Publishers.