HIV Nucleic Acid Testing Program With Automated Internet and Voicemail Systems. Ann Intern Med. 2010;152:I-30. doi: 10.7326/0003-4819-152-12-201006150-00002
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Published: Ann Intern Med. 2010;152(12):I-30.
Human immunodeficiency virus interferes with the body's ability to fight infection and can result in some types of cancer. People spread HIV through blood or other body fluids that contain the virus and during sexual contact. Treatments containing several drugs prevent death and improve the health of people who have HIV.
Most experts recommend screening adults and adolescents for HIV infection so that those with infection obtain appropriate medical care and do not infect others. However, results for standard HIV tests are not usually positive until several weeks after infection occurs. People with recent HIV infection generally have very high amounts of virus in their body fluids and may be more likely to transmit HIV infection to others. A new test called the nucleic acid test can detect the virus sooner after infection than standard tests. However, it is not known how many additional people would be found to be infected if this test were used in screening programs.
To determine whether using the nucleic acid test in addition to standard tests for HIV infection would identify significantly more patients with HIV infection, and to see whether patients would use the Internet to retrieve negative results of nucleic acid tests. Other methods were used to contact people who had positive results.
More than 3000 patients who sought HIV testing in clinics and other testing sites in and near San Diego, California. Many of these sites focus on providing care to people at high risk for HIV infection through sex, such as men who have sex with men.
Patients were first tested for HIV infection with a rapid saliva test. If the results of this test were positive for HIV, a counselor gave patients their test results and a blood sample was obtained for standard HIV tests. If the results were negative, a blood sample was obtained for the nucleic acid test. Patients who took the nucleic acid test were told that if the results were positive, they would be contacted by a staff member within 2 weeks and that if they had not been contacted in 2 weeks, they could call a voicemail number or log in to a Web site to retrieve their results, using an anonymous personal identification number to protect their privacy.
Adding the nucleic acid test to other HIV tests identified significantly more people infected with HIV. Nearly half of those with newly diagnosed HIV had been infected recently. Also, most people used voicemail or the Web site to obtain their negative results from nucleic acid tests.
The study was done in clinics that care for patients who have a higher-than-average risk for recent HIV infection. Use of the nucleic acid test in people at lower risk may not identify as many additional infected people.
Adding the nucleic acid test to HIV screening programs may significantly increase the number of people identified as having HIV infection, especially those who were recently infected. In addition, people will use automated methods to retrieve negative results of nucleic acid tests.
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Infectious Disease, HIV.
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