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Ora Quick News Story

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    Use of Rapid HIV Test in Public Settings Raising Concern About How People Receive Results Access this story and related links online:
    Message 1 of 1 , May 30, 2003
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      Use of Rapid HIV Test in Public Settings 'Raising Concern' About
      How
      People Receive Results

      Access this story and related links online:
      http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=18002


      Seattle health officials today are beginning a "trial run"
      of a rapid HIV
      test in an undisclosed public setting, "raising concern"
      among some gay and
      AIDS advocates about how people will receive their results in public
      places, the Boston Globe reports. The local health department hopes
      that
      the trial run using the test, called OraQuick, will lay the
      groundwork for
      a larger program to offer the test in gay bathhouses and sex clubs.
      The
      health department has drafted protocols for using the rapid test in
      public
      settings, and it currently offers the traditional HIV test, which can
      take
      up to a week to get results, in gay venues. The tests are offered in
      private rooms and administered by health care workers. Since 1998,
      the
      health department has tested 1,200 men in three gay venues in Seattle,
      according to the Globe. Of the 56 men who tested positive -- 4.7% of
      the
      total number tested -- 23%, or 15 men, did not return for their test
      results the next week. "If we had been using a rapid test,
      those ...
      people would have at least received preliminary positive results and
      would
      have been informed of the need to return to our clinic for
      confirmatory
      results," Frank Chaffee, HIV/AIDS program manager for the
      Seattle-King
      County Department of Public Health, said (Sanders, Boston Globe,
      5/30).

      CDC Recommendations


      The CDC in April released a revised HIV/AIDS prevention strategy,
      which
      targets the estimated 200,000 people in the United States who are
      HIV-positive but are unaware of their status. The agency urged local
      health departments to use the rapid HIV test -- which was approved by
      the
      FDA in November 2002 for use in about 40,000 hospitals and clinics
      with
      laboratories -- in all federally funded clinics, as well as places
      such as
      homeless shelters, jails and substance abuse treatment centers. In
      February, President Bush announced expanded availability for OraSure
      Technologies' OraQuick HIV test, which offers results that are 99.6%
      accurate within 20 minutes, to more than 100,000 doctors' offices and
      public health clinics. AIDS groups had advocated for making the test
      more
      widely available to the general public. The CDC also recommended
      simplifying the pre-test counseling process (Kaiser Daily HIV/AIDS
      Report,
      4/17). However, the CDC does not yet have recommendations on the use
      of
      the rapid test or what type of counseling should accompany the test,
      leaving such decisions up to local health authorities. A CDC
      official,
      speaking on the condition of anonymity, said that although the agency
      is
      rethinking counseling strategies, it still believes the process is
      important. According to the Globe, the CDC plans to conduct research
      over
      the next year to determine the best ways to combine counseling with
      the
      rapid test.

      Working in Counseling


      The speed and portability of the new HIV test means that some people
      may
      find out they are HIV-positive in places where counseling and other
      services may not be immediately available, Fred Swanson, executive
      director
      for Gay City Health Project, said. Local health officials say that
      they
      can successfully combine counseling and testing in public locations.
      The
      health department has drafted its own protocols for using the rapid
      test.
      "Our big challenge, and one of the big goals for the Centers for
      Disease
      Control, is to try to increase the number of people with HIV
      infection who
      know that," Chaffee said, adding, "One, because people who
      have HIV and
      don't know it are losing the benefits of good medicine. ... And two,
      we
      know from a variety of studies that when people know they have HIV
      infection, they are much more careful with their sexual and
      needle-sharing
      partners." Although Washington state law requires pre- and
      post-test
      counseling, the law is not specific as to what the counseling should
      entail, according to the Globe. "Are recipients of positive
      test results
      going to be able to internalize the information they've received
      around the
      (new) test when they don't have any time to mull the information
      over?"
      Paul Feldman of Seattle's Lifelong AIDS Alliance asked. Swanson said
      that
      although he is worried about possible negative effects of using the
      rapid
      test in public settings, he said that he is reassured by the fact
      that the
      rapid testing will not occur immediately in gay bathhouses and sex
      clubs.
      "What's exciting to me is that the local health department
      recognizes that
      there may be some challenges, and as such is doing a trial run,"
      he added
      (Boston Globe, 5/30).
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