Rapid HIV test found highly effective

August 15, 2006

A study to be presented this week at the 16th International AIDS Conference in Toronto demonstrates that the new rapid HIV testing protocol is very effective for insuring that people learn whether or not they are infected.

Researchers from the University of California and California State Office of AIDS examined more than 101,000 records from the statewide HIV counseling and testing program for HIV tests done in 2005. More than a quarter of 68,000 clients who were given a conventional HIV test did not return for test results.

The conventional test requires the client to return for results after a two-week wait. Rapid testing, on the other hand, requires only a 20-minute wait and, of the 33,000 clients who received the rapid test, only 2.3 percent failed to get their test results.

Findings are especially important for the 1,045 clients who tested positive for HIV. Of the 623 who took the conventional test, 136 (22 percent) did not return for their test results. But, of 422 who took the rapid test, only six ( 1.4 percent) left the office before receiving test results. The statewide study does not include information from Los Angeles County because those data are not yet available.

The study, just issued by the Universitywide AIDS Research Program (UARP) at the University of California Office of the President, is part of the California HIV Prevention Indicators Project.

"A key component of HIV prevention is for people to know their HIV status," said George Lemp, director of the Universitywide AIDS Research Program. "Rapid testing is an important tool for making that happen and we hope that rapid testing will soon become the norm statewide. We hope this new test can help reduce the estimated 25 percent of persons with HIV who do not know they are infected."

Not all of the data in the report are so encouraging.

There has been little success in reducing high risk sexual behaviors, particularly unprotected sex between men. The widespread use of methamphetamines is demonstrated by the skyrocketing numbers of people who have sought treatment for the drug in recent years. Methamphetamine use has been associated with higher HIV infection rates.

Also, syphilis infection rates over the past six years have risen sharply from 0.8 to 4.3 cases per 100,000 population.

On a positive note, both injection drug use and needle sharing appear to be slowly declining. "We are concerned that many of the indicators are headed in the wrong direction, particularly those related to sexual behavior," Lemp said.

The development of anti-retroviral medications in the mid-1990s vastly improved the health outlook for those with HIV. The annual number who progress to AIDS and the annual number of AIDS deaths both fell dramatically.

However, new HIV infections continue to occur and the result is a rapid annual increase in the total number of people who are infected. This has led, in part, to a dramatic rise in the cost of health services for people with HIV, notably within the California AIDS Drug Assistance Program where annual costs for drugs almost doubled from $145 million in fiscal year 2000-01 to $270 million last fiscal year.

In California, more than 82,000 people with AIDS have died since the epidemic began 25 years ago, and the number of people living with HIV or AIDS has increased dramatically to more than 152,000 today. Nationally, an estimated 3.8 per 1,000 people were living with HIV at the end of 2003. The estimate for California is about 4.2 per 1,000 today.

About two-thirds of AIDS cases in California have been among men who have sex with men. Other high risk groups include injection drug users, transgendered persons, sex workers, female partners of men who have sex with men, and sex partners of injection drug users.

While African Americans represent about 7 percent of California's population, about 18 percent of the AIDS diagnoses have been among African Americans.

The reports are part of the California HIV Prevention Indicators Project coordinated by the Universitywide AIDS Research Program and funded by the California State Office of AIDS at the Department of Health Services.

The purpose of the project is to carefully track the statewide HIV epidemic to assess the impact of prevention programs, and it is part of the Office of AIDS' emphasis on evaluation research to support HIV prevention programs.

Source: University of California