PS06-002 Rap Test Algorithm in Non-Trad Test Stes to Improve Linkage to Care

描述（由申请人提供）：该项目的具体目标是：a)制定使用诊断性快速检测算法的书面协议；b)确定实施的最佳做法；c)评估这种算法的优缺点；d)验证诊断性艾滋病毒快速检测算法的使用；e)评估根据该算法而不是目前的做法获得初步阳性结果的未感染艾滋病毒客户的比例。f)评估根据算法（而不是现行做法）得知确认的艾滋病毒阳性检测结果的艾滋病毒感染客户的比例；g)评估通过算法（而不是现行做法）诊断后转诊并接受初级医疗保健的艾滋病毒感染客户的比例；h)评估使用诊断算法进行艾滋病毒检测的费用。

DESCRIPTION (provided by applicant): The specific aims of this project are to: a) develop written protocols for utilizing a diagnostic rapid testing algorithm, b) identify best practices for implementation, c) evaluate the advantages and disadvantages of such an algorithm, d) to validate the use of a diagnostic rapid HIV testing algorithm, e) assess the proportion of non-HIV-infected clients who receive a preliminary positive result according to the algorithm as opposed to current practice, f) assess the proportion of HIV-infected clients who receive disclosure of a confirmed HIV positive test result according to the algorithm as opposed to current practice, g) assess the proportion of HIV-infected clients who are referred to and receive primary medical care as a result of diagnosis through the algorithm as opposed to current practice, h) assess the cost of HIV testing with a diagnostic algorithm. The broad, long-term objectives of this project are in line with the agencies' missions to: a) increase the number of HIV-infected individuals who learn their status and enter into early medical care and prevention services to prevent transmission to others, b) reduce the burden of rapid HIV testing program implementation and maintenance on the staff of performance sites, and c) improve the efficiency and quality of HIV testing services available for high-risk and hard to reach clientele. Seven intervention sites will be providing rapid HIV testing according to the following algorithm: an FDA approved CLIA-waived rapid test will be run. If the test is reactive, a second CLIA-waived rapid test will be run. If that test is also reactive, the client will be diagnosed as HIV-positive and linked to medical care. Blood will be drawn and an appointment will be scheduled for one week later to disclose the results of confirmatory testing. If the second rapid test is non-reactive, then a third rapid test will be run to determine diagnosis and blood will be drawn for confirmation. Thirteen comparison sites will be providing rapid HIV testing according to the current standard of practice: a CLIA-waived rapid HIV test is run, and if preliminary positive, blood is drawn for confirmation. At the confirmatory disclosure appointment one week later, the client is diagnosed with HIV and linked to medical care. Assistance will be provided to both intervention and comparison sites to enhance the tracking of linkages to medical care and other necessary support services for all individuals testing HIV-positive. This research is relevant to public health because early identification of HIV-positive people and linkage to medical care reduces the rate of transmission and the burden of providing late-diagnosis medical care.