Same day testing for HIV

Testing for HIV antibodies should be offered on a same-day basis

We review our experience of testing over 22 000 patients who requested HIV antibody results on a same-day basis. We find that such a service can be provided without compromising the quality of laboratory work or increasing the cost per test. This service is popular with patients, who appear to contain high risk individuals because 2.8 were shown to be HIV-positive. By reducing bureaucratic hurdles, same-day testing clinics may encourage people to come forward for HIV testing and provide a means of offering chemotherapy (directed either at HIV itself or at opportunistic infections) without delay. We thus argue for the proposition.Copyright 1998 John Wiley & Sons, Ltd.

Testing for HIV antibodies should not be offered on a same-day basis

Same-day testing for HIV is now offered in 16 of Genitourinary Medicine clinics in the UK and in 31 of those in London, and supposedly offers a reduction in client waiting time and anxiety levels. 'Same-day' is, however, misleading as the majority of same-day testing services provide same-day negative results only, with confirmed positive results being available no earlier than from a routine drop-in clinic. In addition, as most same-day testing services are appointment-based, patients would generally receive their results much sooner if they were to attend a drop-in clinic. The provision of a same-day service causes considerable problems for the virology laboratory. Dedicated staff may be required and different assays and reporting protocols will need to be implemented. In addition to the considerable pressure, and therefore stress, which is placed on staff providing a same-day service, it is likely that same-day testing will result in significant additional cost. Current assay systems and laboratory protocols permit random access of samples which allows urgent samples to be tested immediately they are received by the laboratory. The judicious use of this facility would offer the equivalent of a same-day testing service for those patients whose anxiety health advisors felt warranted an urgent result; would provide others with a result within 2 days at the most; would be cheaper, thus releasing scarce resources; and would reduce staff stress. In conclusion, we argue against the proposition. Copyright 1998 John Wiley & Sons, Ltd.