Research On The HIV Testing Strategy And Mode Fitting VCT Population

BackgroundAIDS Voluntary Counseling and Testing(VCT) is an important measure for AIDS prevention in our country.So,a testing strategy and mode that can be used in VCT sites will be very helpful to the AIDS prevention.ObjectivesTo evaluate the feasibility of rapid HIV testing strategy used in VCT sites and find a testing mode that can be used in VCT sites.Methods1.Samples were collected with the Volunteer' s permission.The samples were screened by HIV rapid test(RT) and enzyme-linked immunoassay assay(ELISA),and positive samples were confirmed by western blot(WB) assay.2.HIV-1 positive samples were tested by BED-CEIA assay.3.HIV window-period infectors were found in HIV high-risk groups by pooled HIV RNA RT-PCR assay.4.Data was analyzed by EXCEL or SPSS.The HIV testing mode that can be used in VCT sites of our country was concluded.Result1.Overall,10313 samples were collected from 27 VCT sites,388 Samples were HIV antibody positive by WB assay.There was no statistic significant difference(X²=1.59,P>0.05),no matter one HIV rapid test reagent(RT,or RT₂) or both of them were used to screen HIV antibody negative samples.But the difference was statistic significance(X ₁²=17.96,P<0.005;X₂²=20.41,P<0.005),when used one HIV rapid test reagent(RT₁ or RT₂) or both of them to screen HIV antibody positive samples.In the HIV positive samples that screened by both RT₁ and RT₂, 372 samples were S/CO≥6.0,and all of them were HIV antibody negative samples by WB assay;Four samples were 1.0≤S/CO<6.0,and 1 of them were HIV antibody negative by WB assay;Four samples were S/CO<1.0, and all of them were HIV antibody negative samples by WB assay.There were 63 samples had conflictive results by RTi and RT₂.In these samples, Six samples were HIV antibody positive samples by ELISA(only 2 of them were HIV antibody positive samples by WB assay),57 samples were HIV antibody negative samples by ELISA(four of them were HIV antibody uncertain samples,53 of them were HIV antibody negative samples by WB assay).2.In this study,in which 385 samples were tested by BED-CEIA assay. Sixty-three samples were HIV recent infection ones.No persons who are on HAART and AIDS were found according to their document.Count of CD4 cell of HIV antibody positive samples couldn' t be gotten.3.The proportion of HIV antibody positive person whose education level is under junior high school is 95.88%.HIV recent infection person accounts for different proportion to HIV antibody positive ones in the groups of Gender,Age,Education and risk behavior,but the difference is no statistic significance.4.In this study,7 HIV window-period infectors were found.The cost of one RT-PCR test is 700 Yuan.In all,281 tests were done,9832 samples were tested,and the total cost of pooled HIV RNA RT-PCR was about 196,700 Yuan.The cost of each sample was about 20.02 Yuan.Conclusions1.RT₁+RT₂+ELISA HIV testing strategy can be used in the VCT sites of middle China.This new strategy appears to be reliable,simple,feasible, rapid and cost-efficient in VCT sites.2.BED-CEIA can be used in VCT sites,but should notice:(1) Unless making sure that enough HIV positive samples(not less than 20 samples) can be gotten,BED-CEIA should be used in the VCT sites where HIV positive rate are more than 5%.(2) BED-CEIA can' t be used to evaluated HIV-1 incidence of VCT sites, but it can be used to analyze the characters of HIV recent infection person.(3) In order to get enough HIV positive samples,assure the quality of samples,get real and detailed personal document,BED-CEIA should be used in better-work VCT sites.(4) Repeated samples must be excluded by its personal document or by other means.3.Person with insecure sex behavior and lower education level should be noticed.4.Pooled HIV RNA RT-PCR assay can be used to screen HIV window-period infectors in VCT sites.