Assessing Interpretation Proficiency of Rapid HIV Assays in Non-Laboratory Settings: Ensuring the Quality of Testing

National Serology Reference Laboratory, Australia, St Vincent's Institute, Fitzroy, Victoria, Australia; Department of Medicine at St Vincent's Health, University of Melbourne, Fitzroy, Victoria, Australia; Department of Microbiology and Immunology, University of Melbourne, Parkville, Victoria, Australia

^* To whom correspondence should be addressed. Email: liz{at}nrl.gov.au.

	Abstract

Rapid antibody tests for the detection of human immunodeficiency virus (HIV) offers an effective means of providing a timely result of HIV sero-status to individuals. Increased use of rapid HIV antibody tests outside the laboratory has highlighted the need for new, cost-effective, quality assurance methods to be developed for use in non-laboratory-based and resource-limited settings. Photographed rapid HIV test results were used in a modified external quality assessment scheme to assess interpretation proficiency and therefore to assess the feasibility of using this method as a basis for a quality assessment program for non-laboratory-based testing. Participants (n=148), both experienced and inexperienced in the performance and interpretation of rapid HIV testing, interpreted photographed results of 5 rapid HIV assays. These were scored according to the degree of technical discordance. Error scores were grouped according to each participant's technical experience. Accuracy of interpretation for four of the five assays was between 80 and 97% indicating photographed results of samples, including those difficult to read or borderline, could be used to assess the proficiency of test operators in interpreting results. Participants had greater difficulty in interpreting samples of weak reactivity; this was consistent across the five assays. Experience played an important role in accurate interpretation, with experienced laboratory participants exhibiting greater proficiency (p<0.05) in interpreting results of three of the five rapid HIV assays. It was established that photographed results of rapid HIV assays could be interpreted with accuracy and demonstrated that prior experience resulted in more accurate interpretation performance.