Patients 'may not feel prepared' for rapid HIV test results
7 November 2008
A total of 4810 women from South Africa’s rural KwaZulu-Natal area took the rapid test, but just 166 opted to receive their results on the same day. More preferred to return for their results at a later date instead.
“This was a somewhat surprising result, and contrary to other reports which suggest that clients are more likely to receive their results with rapid tests, as opposed to conventional tests,” said Ruth Bland, from the Africa Centre for Health and Population Studies, who led the study.
Rapid tests are intended to simplify and speed up the process - vital in resource-poor areas - and may help boost the number of people signing up for HIV testing.
In the study, women attending antenatal clinics in KwaZulu-Natal were offered a rapid test alongside the standard ELISA test for HIV, which takes two weeks to process and requires samples to be sent to a separate laboratory.
Yet the majority of women chose not to get their results on the same day, despite their availability. The exact reasons for this are unknown, but the researchers speculate that that some participants may not have felt adequately prepared for the results.
“Women may not realise that they are going to be tested for HIV at the clinic, and have already received a lot of information both about pregnancy and about HIV. They may feel as if they cannot take in further information at this visit,” said Bland.
“Also, women are usually not accompanied by other people when they come to antenatal clinics - they may feel they wish to go home and discuss with their partner or another relative, before hearing their results.”
The extra waiting period could also have been a factor, she said. “This is a rural area, and women often walk long distances to clinic, and wait for 3-4 hours at the clinic. They may be tired and need to get home, and the option of returning for results later may seem acceptable.”
Bland said counsellors and those training them should be made aware of the findings, “so that high-quality counselling can be given, preparing clients for same-day results and acknowledging that some people might not feel ready to receive their results immediately”.
However, she said rapid tests still have a key role to play in resource-poor settings.
“The tests are cheap, do not involve transport to take specimens to a laboratory and a system to return results to clinics. Same-day results ensure that people receive their results and healthcare can be targeted appropriately. If vertical transmission from mother to child is to be reduced, it is critical that pregnant women know their HIV status, so that they can receive appropriate care and treatment.”
Image: Women waiting for counselling at an AIDS clinic; USAID/K Burns
References
Ntombizodumo B M. Rapid Testing May Not Improve Uptake of HIV Testing and Same Day Results in a Rural South African Community: A Cohort Study of 12 000 Women. PLoS ONE;3(10):e3501.