Outcomes of blood and oral fluid rapid HIV testing: a literature review, 2000-2006.

Rapid HIV antibody testing is a new technology whose implementation promises to facilitate the early detection of persons with HIV/AIDS. The goal of this study was to review and summarize the literature from 2000-2006 regarding four outcomes of rapid (including both blood and oral fluid) HIV testing: rates of client acceptance; rates of clients' receiving their test results; rates of entry into medical care for those found to be HIV positive; and the efficacy of prevention counseling after testing. A total of 116 studies in peer-reviewed journals were screened. Twenty-six met the screening criteria (published in peer-reviewed journals and focused on at least one of the outcomes of interest) and were selected for review. Considerable variation was found in client acceptance rates with the highest rates among pregnant women in labor and delivery units and the lowest rates in needle exchange and bath-house settings. The evidence shows that most persons tested with a rapid test receive their test result. Three studies on entry into medical care among those who were newly identified HIV positive found rates of 47%, 82%, and 97% of clients adhering to their first medical appointment. No long-term medical follow-up studies were found. Only one study examined the efficacy of prevention counseling after rapid testing and found no statistically significant differences in the number of sexually transmitted diseases (STDs) conventional versus rapid HIV testers contracted following testing.