Community-based HIV testing programs generally use only HIV antibody testing, but nucleic acid testing (NAT) can detect the presence of HIV earlier. Researchers at the University of California, San Diego School of Medicine studied more than 3,000 patients who sought HIV testing in community-based clinics in or near San Diego to examine the yield of testing with a rapid test plus NAT and to see whether patients would be willing to access their results by phone or computer.

Their study, published June 14 in the Annals of Internal Medicine, showed that NAT testing increased the HIV detection yield by 23%, and that a large majority of study participants received their negative test results by automated phone or internet systems.

"While the findings may not be generalized to all populations and testing programs, we did find that NAT programs that include automated systems for result reporting can increase case yield, especially in settings that cater to those men having sex with men," said the study's first author Sheldon Morris, MD, MPH, assistant clinical professor at UC San Diego's Antiviral Research Center.

Despite decades of prevention efforts in the U.S., the incidence rate of HIV has remained stable. Because the earliest stages of HIV infection represent a period of maximum infectiousness, early and accurate detection is critical to control the HIV epidemic.

"Extending the use of NAT to routine HIV testing programs might help decrease the HIV incidence rate by identifying persons with acute infection that would otherwise be missed through routine screening," said Morris. "In addition, automated reporting of negative results may prove an acceptable and less resource intense alternative to face-to-face reporting."

The patients were first tested for HIV with a rapid saliva test. If the result was positive, a counselor informed the patient and blood was obtained for a standard HIV test. If the result was negative, blood was obtained for a NAT. Nearly one quarter of persons with identified cases of HIV had positive results only by NAT testing. More than two-thirds of patients with negative NAT results retrieved them via computer or voicemail.

Most participants in the San Diego study (56%) and those with HIV (91%) were men having sex with men. According to the UCSD researchers, those with higher incomes, younger ages, no testing at substance abuse rehabilitation centers, no recent syphilis and no methamphetamine use were more likely to access negative NAT results by either internet or voicemail systems.

Contributors to the study were Susan J. Little, MD, Terry Cunningham, MAOM, Richard S. Garfein, MPH, PhD, Douglas D. Richman, MD, and Davey Smith, MD, MAS; all of UC San Diego School of Medicine.

The study was supported by funding from the California HIV/AIDS Research Program and the National Institutes of Health.

Source: University of California, San Diego Health Sciences

A new campaign is using the power and outreach of football to unite the world around a common cause-preventing the transmission of HIV from mother to child. Launched in South Africa by the UNAIDS Executive Director, Michel Sidibé, international musician Akon, UNAIDS Goodwill Ambassador and producer of the World Cup opening ceremony, Lebo M, UNAIDS National Goodwill Ambassador, Jimmie Earl Perry, and Kirsten Nematandani, President of the South African Football Association. The campaign aims to ensure an HIV-free generation by the 2014 FIFA World Cup to be held in Rio de Janeiro, Brazil.

Each year, an estimated 430 000 babies are born with HIV globally, the large majority in Africa. Over the course of a 90-minute football match, nearly 80 babies will become newly infected with HIV. In many parts of Africa, AIDS-related illness is the leading cause of death among infants and young children.

Through the campaign-backed by international football stars and UNAIDS Goodwill Ambassadors Michael Ballack of Germany and Emmanuel Adebayor of Togo-captains of 32 World Cup qualifying teams have been invited to sign the appeal: "From Soweto to Rio de Janeiro, give AIDS the red card and prevent babies from becoming infected with HIV." Nineteen captains have already signed on, including host country South Africa and defending champion Italy.

"By the next football World Cup we can virtually eliminate HIV transmission to babies," said UNAIDS Executive Director Michel Sidibé who attended the campaign launch in South Africa. "Let us give AIDS the red card permanently."

The lives of mothers and their babies can be saved through a combination of HIV testing and counselling, access to effective antiretroviral prophylaxis and treatment, safer delivery practices, family planning, and counselling and support for optimal infant feeding practices.

An estimated 33.4 million people are living with HIV worldwide. Since 2001, there has been a 17% reduction in new HIV infections globally. However, for every two people who access antiretroviral treatment, five more become newly infected with HIV.

Source

UNAIDS