3. Promoting HIV Testing in Diverse Populations

Confirmatory Tests

A negative HIV test finding—whether it is
performed at the point of care or in a laboratory—is generally considered to be a definitive finding—except in cases where a patient is experiencing symptoms of acute HIV infection. For positive findings, the confirmatory Western blot assay (Table) can directly detect HIV antibodies, but because it may not be capable of detecting early antibodies, its results can be discordant. For a patient who showed a positive result from an initial rapid HIV test for which that positive finding could not be confirmed, the clinician should obtain a further specimen to
be assayed for HIV antigen and should advise the patient to be retested in 2 weeks.

Table I
Available HIV Testing Technologies[FDA List]

	Purpose	Sample Used	Trade Names
Conventional blood tests	Diagnostic	Serum/plasma	GS rLAV EIA Avioq HIV-1 Microelisa System
Rapid tests	Diagnostic	Serum/blood (by venipuncture or finger stick)	INSTI™ HIV-1 Antibody Test Kit Reveal Rapid HIV-1 Antibody Test Uni-Gold Recombigen HIV
Oral test	Diagnostic	Oral fluid	OraSure HIV-1 Oral Specimen Collection Device
Home test	Diagnostic: self-use by people who wish to obtain anonymous HIV testing	Dried blood spot	Home Access HIV-1 Test System
Confirmatory tests	Diagnostic	Serum/plasma	Cambridge Biotech HIV-1 Western Blot Kit GS HIV-1 Western Blot
Urine test	Diagnostic	Urine	Maxim Biotech HIV-1 Urine EIA
Acute/primary infection tests	Diagnostic detection of HIV antigen	Plasma/serum	APTIMA HIV-1 RNA Qualitative Assay

This table of approved HIV tests is not intended to be comprehensive, but as a guide to practitioners responsible for implementing screening programs. For example, this listing does not include assays that are capable of detecting antibodies to HIV-2 or those used in testing donated organs and tissues. [FDA list]

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