HIV rapid diagnostic testing by lay providers in a key population-led health service programme in Thailand

• Published in: Journal of Virus Eradication 2018-01, Vol.4 (1), p.12-15
• Main Authors: Wongkanya, Rapeeporn, Pankam, Tippawan, Wolf, Shauna, Pattanachaiwit, Supanit, Jantarapakde, Jureeporn, Pengnongyang, Supabhorn, Thapwong, Prasopsuk, Udomjirasirichot, Apichat, Churattanakraisri, Yutthana, Prawepray, Nanthika, Paksornsit, Apiluk, Sitthipau, Thidadaow, Petchaithong, Sarayut, Jitsakulchaidejt, Raruay, Nookhai, Somboon, Lertpiriyasuwat, Cheewanan, Ongwandee, Sumet, Phanuphak, Praphan, Phanuphak, Nittaya
• Format: Article
• Language: English
• Subjects: Original Research; Performance, HIV, rapid diagnostic test (RDT), lay providers, key population-led
• ISSN: 2055-6640; 2055-6659
• DOI: 10.1016/S2055-6640(20)30235-1

Introduction:  Rapid diagnostic testing (RDT) for HIV has a quick turn-around time, which increases the proportion of people testing who receive their result. HIV RDT in Thailand has traditionally been performed only by medical technologists (MTs), which is a barrier to its being scaled up. We evaluated the performance of HIV RDT conducted by trained lay providers who were members of, or worked closely with, a group of men who have sex with men (MSM) and with transgender women (TG) communities, and compared it to tests conducted by MTs. Methods:  Lay providers received a 3-day intensive training course on how to perform a finger-prick blood collection and an HIV RDT as part of the Key Population-led Health Services (KPLHS) programme among MSM and TG. All the samples were tested by lay providers using Alere Determine HIV 1/2. HIV-reactive samples were confirmed by DoubleCheckGold Ultra HIV 1&2 and SD Bioline HIV 1/2. All HIV-positive and 10% of HIV-negative samples were re-tested by MTs using Serodia HIV 1/2. Results:  Of 1680 finger-prick blood samples collected and tested using HIV RDT by lay providers in six drop-in centres in Bangkok, Chiang Mai, Chonburi and Songkhla, 252 (15%) were HIV-positive. MTs re-tested these HIV-positive samples and 143 randomly selected HIV-negative samples with 100% concordant test results. Conclusion:  Lay providers in Thailand can be trained and empowered to perform HIV RDT as they were found to achieve comparable results in sample testing with MTs. Based on the task-shifting concept, this rapid HIV testing performed by lay providers as part of the KPLHS programme has great potential to enhance HIV prevention and treatment programmes among key at-risk populations.