A comparison of effectiveness between oral rapid testing and routine serum-based testing for HIV in an outpatient dental clinic in Yuxi Prefecture, China: a case-control study

Shifu Li; Shu Su; Shunxiang Li; Liangmin Gao; Ying Cai; Jincui Fu; Chunyuan Guo; Wei Lu; Feng Cheng; Jun Jing; Liang Chen; Lei Zhang

doi:10.1136/bmjopen-2016-014601

A comparison of effectiveness between oral rapid testing and routine serum-based testing for HIV in an outpatient dental clinic in Yuxi Prefecture, China: a case-control study

BMJ Open. 2017 Jun 30;7(6):e014601. doi: 10.1136/bmjopen-2016-014601.

Authors

Shifu Li¹, Shu Su², Shunxiang Li¹, Liangmin Gao^{1

3}, Ying Cai¹, Jincui Fu¹, Chunyuan Guo¹, Wei Lu⁴, Feng Cheng³, Jun Jing³, Liang Chen¹, Lei Zhang^{2

3

5

6}

Affiliations

¹ Division of HIV/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China.
² School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
³ Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.
⁴ Department of Stomatology, The First People's Hospital of Yuxi, Yuxi Prefecture, Yunnan, China.
⁵ Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
⁶ Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.

Abstract

Objective: To compare the outcomes of routine provider-initiated HIV testing and counselling (PITC) and oral rapid HIV testing for dental clinic outpatients in a hospital.

Design: We employed a case-control study design and recruited dental outpatients into routine serum-based and oral rapid testing groups. We compared the acceptance, completion and result notification rate between groups.

Setting: A dental outpatient clinic in the Yuxi People's Hospital, Yunnan.

Participants: A total of 758 and 816 dental outpatients were enrolled for routine and oral rapid testing, respectively.

Results: The percentage of participants willing to receive routine HIV testing was 28.1% (95% CI 24.9% to 31.3%) and 96.1% (95% CI 94.8% to 97.4%, χ2=186.4, p<0.001) for the rapid testing. Among accepted participants, the percentage of participants who received HIV testing was 26.8% (95% CI 20.9% to 32.7%) in the routine testing group and 100.0% in the oral rapid HIV testing group (χ2=77.5, p<0.001). About 93.0% of routine testers returned for the test results on the next day, whereas all rapid testers received their test results on the same day (χ2=34.6, p<0.001). These correspond to an overall completion rate of 7.0% (95% CI 5.2% to 8.8%) and 96.1% (95% CI 94.8% to 97.4%, p<0.001), respectively. Among the 545 patients who declined routine serum-based HIV testing, the main reasons included, an unnecessary hassle (254/545, 46.6%), having been previously tested (124/545, 22.8%) and self-perceived low risk of HIV infection (103/545, 18.9%). In contrast, only 32 individuals declined oral rapid testing, and having received a previous test was the primary reason. Three patients in the rapid testing group were later confirmed HIV-positive, yielding an HIV prevalence of 0.38%.

Conclusion: Oral rapid HIV testing is a feasible and efficient approach in a clinical setting.

Keywords: Dental clinic outpatients; HIV; Improve; Oral rapid test; PITC.

Publication types

Comparative Study

MeSH terms

Adolescent
Adult
Case-Control Studies
China
Dental Clinics*
Developing Countries
Female
HIV Infections / blood
HIV Infections / diagnosis*
Humans
Male
Mass Screening / statistics & numerical data*
Middle Aged
Patient Acceptance of Health Care / psychology
Patient Acceptance of Health Care / statistics & numerical data*
Point-of-Care Testing / statistics & numerical data*
Time Factors
Young Adult