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A comparison of effectiveness between oral rapid testing and routine serum-based testing for HIV in an outpatient dental clinic in Yuxi Prefecture, China: a case-control study.

A comparison of effectiveness between oral rapid testing and routine serum-based testing for HIV in an outpatient dental clinic in Yuxi Prefecture, China: a case-control study.
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Li S, Su S, Li S, Gao L, Cai Y, Fu J, Guo C, Lu W, Cheng F, Jing J, Chen L, Zhang L,


Li S, Su S, Li S, Gao L, Cai Y, Fu J, Guo C, Lu W, Cheng F, Jing J, Chen L, Zhang L, (click to view)

Li S, Su S, Li S, Gao L, Cai Y, Fu J, Guo C, Lu W, Cheng F, Jing J, Chen L, Zhang L,

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BMJ open 2017 06 307(6) e014601 doi 10.1136/bmjopen-2016-014601

Abstract
OBJECTIVE
To compare the outcomes of routine provider-initiated HIV testing and counselling (PITC) and oral rapid HIV testing for dental clinic outpatients in a hospital.

DESIGN
We employed a case-control study design and recruited dental outpatients into routine serum-based and oral rapid testing groups. We compared the acceptance, completion and result notification rate between groups.

SETTING
A dental outpatient clinic in the Yuxi People’s Hospital, Yunnan.

PARTICIPANTS
A total of 758 and 816 dental outpatients were enrolled for routine and oral rapid testing, respectively.

RESULTS
The percentage of participants willing to receive routine HIV testing was 28.1% (95% CI 24.9% to 31.3%) and 96.1% (95% CI 94.8% to 97.4%, χ2=186.4, p<0.001) for the rapid testing. Among accepted participants, the percentage of participants who received HIV testing was 26.8% (95% CI 20.9% to 32.7%) in the routine testing group and 100.0% in the oral rapid HIV testing group (χ2=77.5, p<0.001). About 93.0% of routine testers returned for the test results on the next day, whereas all rapid testers received their test results on the same day (χ2=34.6, p<0.001). These correspond to an overall completion rate of 7.0% (95% CI 5.2% to 8.8%) and 96.1% (95% CI 94.8% to 97.4%, p<0.001), respectively. Among the 545 patients who declined routine serum-based HIV testing, the main reasons included, an unnecessary hassle (254/545, 46.6%), having been previously tested (124/545, 22.8%) and self-perceived low risk of HIV infection (103/545, 18.9%). In contrast, only 32 individuals declined oral rapid testing, and having received a previous test was the primary reason. Three patients in the rapid testing group were later confirmed HIV-positive, yielding an HIV prevalence of 0.38%. CONCLUSION
Oral rapid HIV testing is a feasible and efficient approach in a clinical setting.

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