{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:08:13Z","timestamp":1790204893568,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"S6","license":[{"start":{"date-parts":[[2017,8,29]],"date-time":"2017-08-29T00:00:00Z","timestamp":1503964800000},"content-version":"vor","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009054","name":"U.S. President\u2019s Emergency Plan for AIDS Relief","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of the International AIDS Society"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Introduction<\/jats:bold>: Population\u2010wide HIV testing services (HTS) must be delivered in order to achieve universal antiretroviral treatment (ART) coverage. To accurately deliver HTS at such scale, non\u2010facility\u2010based HIV point\u2010of\u2010care testing (HIV\u2010POCT) is necessary but requires rigorous quality assurance (QA). This study assessed the performance of community\u2010wide HTS in Zambia and South Africa (SA) as part of the HPTN 071 (PopART) study and explores the impact of quality improvement interventions on HTS performance.<\/jats:p><jats:p><jats:bold>Methods<\/jats:bold>: Between 2014 and 2016, HIV\u2010POCT was undertaken within households both as part of the randomly selected HPTN 071 research cohort (Population Cohort [PC]) and as part of the intervention provided by community HIV\u2010care providers. HIV\u2010POCT followed national algorithms in both countries. Consenting PC participants provided a venous blood sample in addition to being offered HIV\u2010POCT. We compared results obtained in the PC using a laboratory\u2010based gold standard (GS) testing algorithm and HIV\u2010POCT. Comprehensive QA mechanisms were put in place to support the community\u2010wide testing. Participants who were identified as having a false negative or false positive HIV rapid test were revisited and offered retesting.<\/jats:p><jats:p><jats:bold>Results<\/jats:bold>: We initially observed poor sensitivity (45\u201354%, 95% confidence interval [CI] 31\u201369) of HIV\u2010POCT in the PC in SA compared to sensitivity in Zambia for the same time period of 95.8% (95% CI 93\u201398). In both countries, specificity of HIV\u2010POCT was &gt;98%. With enhanced QA interventions and adoption of the same HIV\u2010POCT algorithm, sensitivity in SA improved to a similar level as in Zambia.<\/jats:p><jats:p><jats:bold>Conclusions<\/jats:bold>: This is one of the first reports of HIV\u2010POCT performance during wide\u2010scale delivery of HTS compared to a GS laboratory algorithm. HIV\u2010POCT in a real\u2010world setting had a lower sensitivity than anticipated. Appropriate choice of HIV\u2010POCT algorithms, intensive training and supervision, and robust QA mechanisms are necessary to optimize HIV\u2010POCT test performance when testing is delivered at a community level. HIV\u2010POCT in clients who did not disclose that they were on ART may have contributed to false negative HIV\u2010POCT results and should be the topic of future research.<\/jats:p>","DOI":"10.7448\/ias.20.7.21780","type":"journal-article","created":{"date-parts":[[2017,7,12]],"date-time":"2017-07-12T09:26:36Z","timestamp":1499851596000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Understanding low sensitivity of community\u2010based HIV rapid testing: experiences from the HPTN 071 (PopART) trial in Zambia and South Africa"],"prefix":"10.1002","volume":"20","author":[{"given":"Peter","family":"Bock","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Comfort","family":"Phiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estelle","family":"Piwowar\u2010Manning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Kosloff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nomtha","family":"Mandla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Young","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anelet","family":"James","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ab","family":"Schaap","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Scheepers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Donnell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Griffith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafaa","family":"El\u2010Sadr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwame","family":"Shanaube","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nulda","family":"Beyers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Hayes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Fidler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Ayles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the HPTN 071 (PopART) Study Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,8,29]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"UNAIDS.Country factsheets Viet Nam 2015 [UNAIDS website].UNAIDS; 2015[cited 2016 Jun 22]. 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