The Importance of Rapid HIV Tests and Recommendations for Managing their Results

Global strategy to reduce late diagnosis

The main strategy to reduce late diagnosis is the promotion of HIV testing. In this regard, UNAIDS calls for a commitment on the part of the international community to expand HIV testing (ONUSIDA, 2018).

To celebrate the European Testing Week (23-30 November 2018), the ECDC published a guide on the offer of integrated testing for HIV, Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV). The aim of this strategy is to prevent these infections from posing a public health threat by 2030, as described in the Sustainable Development Goals.

Individuals who should be offered integrated testing are the following: men who have sex with men (MSM); transgender individuals; individuals who inject drugs; sexual partners or injection partners of individuals diagnosed with HIV, HBV, and HCV; immigrants from high-prevalence countries; those living with HBV-infected individuals; the homeless; individuals engaged in prostitution; prisoners; pregnant women; haemodialysis patients; individuals who have received blood products or organs or who have been operated on before adequate safety and quality regulations were in place (ECDC, 2018).

Method of use

Rapid HIV tests are single-use and can test blood, plasma, or oral fluid samples. It is important to strictly adhere to the instructions for the use of these tests, as the way they are carried out differs from one to another. These test kits should be kept at room temperature (between 18 and 30 degrees Celsius). Fasting is not required and no evidence of drug interaction has been shown Ministerio de Sanidad Consumo y Bienestar Social y Colegio General de Colegios Oficiales de Farmacéuticos, 2017

Who is the target group for rapid HIV testing?

Rapid testing is generally used in community settings to facilitate access to HIV testing for individuals who are most vulnerable to HIV infection.

Rapid HIV testing targets people in groups with a prevalence of HIV infection above 1%, because, otherwise, the likelihood of a false positive result increases (i.e. the test being positive without there being any antibodies to HIV in the sample).

Interpretation of rapid test results

Information for the individual who took the test

The consultation for a rapid test result is an opportunity for individuals to explore and understand confidentially their risks of becoming infected with HIV and to learn the results of their HIV tests (ONUSIDA, 2018). If the individual is at risk or has continued to engage in risky practices, HIV testing should be offered according to current recommendations (Ministerio de Sanidad Consumo y Bienestar Social, 2014).

For those who engage in risky practices, UNAIDS recommends reinforcing testing by pointing out the benefits of knowing one’s serostatus(Adaptado de (ONUSIDA, 2018). ):

Acting on accidental exposure to HIV

Non-occupational post-exposure prophylaxis (nPEP) for HIV is a prevention measure that is intended to avoid becoming infected with HIV after accidental exposure to HIV outside of the healthcare setting through sexual or parenteral routes (Ministerio de Sanidad Consumo y Bienestar Social, 2019).

If the individual has been exposed to a risk situation in the past 72 hours, they should be referred to a hospital emergency department to assess the appropriateness of initiating nPEP. It is recommended that the treatment be started within 6 hours after the incident, since the effectiveness of the treatment decreases with the passage of time. The nPEP regimen lasts about 28 days and requires medical follow-up (Ministerio de Sanidad Consumo y Bienestar Social, 2019).