The quality of rapid HIV testing in South Africa: an assessment of testers’ compliance.

Aziza Mwisongo, Karl Peltzer, Neo Mohlabane, Bomkazi Tutshana
1. HIV/AIDS/STIs/and TB (HAST), Human Sciences Research Council, Pretoria, Durban, South Africa.
2. Department of Research & Innovation, University of Limpopo, Turfloop Campus, Private Bag X1106,
Sovenga 0727, South Africa.
3. ASEAN Institute for Health Development, Madidol University, Salaya, Phutthamonthon, Nakhonpathom,
Thailand, 73170.

Abstract
Background: The aim of this study was to assess the quality of rapid HIV testing in South Africa.

Method:A two-stage sampling procedure was used to select HCT sites in eight provinces of South Africa. The study employed  both semi-structured interviews with HIV testers and observation of testing sessions as a means of data collection. In total, 63  HCT sites (one HIV tester per site) were included in the survey assessing qualification, training, testing practices and attitudes  towards rapid tests. Quantitative data was analysed using descriptive statistics and qualitative data was content analysed.

Results:Of the 63 HIV testers, 20.6% had a nursing qualification, 14.3% were professional counsellors, 58.7% were lay HIV  counsellors and testers and 6.4% were from other professions. Most HIV testers (87.3%) had had a formal training in testing,  which ranged between 10-14 days, while 6 (9.5%) had none. Findings revealed sub-standard practices in relation to testing. These  were mainly related to non-adherence to testing algorithms, poor external quality control practices, poor handling and communication of discordant results.

Conclusion: Quality of HIV rapid testing may be highly compromised through poor adherence to guidelines as observed in  our study.

Keywords: HIV rapid testing, quality, health workers, quality assurance