Local governments grapple with which HIV tests to provide

Local governments are grappling with which HIV tests to provide to their citizens, with some favoring new rapid test kits that can provide results in about 20 minutes and others opting for HIV RNA screenings that take much longer to get results back to those being tested but which can detect HIV infection in its earliest stages, The New York Times reports. Rapid HIV tests search for HIV antibodies, which typically take four weeks or longer to appear in the bloodstream, making them unreliable for detecting very early HIV infections. But the advantages of the tests, say HIV experts, is that they can produce results in about 20 minutes, allowing those being tested to receive near instantaneous results. With standard HIV screenings, blood samples are sent to labs for testing, and results aren't available for days or even weeks. As many as one third of people receiving standard HIV screenings don't return for their results. However, HIV RNA tests can detect even tiny amounts of virus in the blood within about 10 days of infection, allowing health workers to identify people who have been very recently infected. Because blood-based levels of HIV can soar to extremely high levels during early stages of infection, those who are newly infected can easily transmit the virus to others through unprotected sex or through shared injection drug paraphernalia. Identifying HIV cases as early as possible could help prevent these HIV-positive people from unknowingly passing the virus to others. Some studies have also shown that treating HIV infection in its earliest stages may also significantly slow HIV disease progression. Because both forms of HIV testing have distinct advantages and disadvantages, health officials often struggle with which approach they should adopt, the Times reports. Government officials in New York City and throughout New York State have opted for the rapid HIV testing because of its quick results and the fact that the tests can be administered through street-level HIV outreach programs. Health officials in San Francisco and North Carolina are continuing to rely on HIV RNA tests because of their ability to detect early HIV infections. AIDS experts say it would be ideal to offer both tests simultaneously, but health officials say that it would be too costly and too difficult to train HIV outreach workers to administer and document the more complicated HIV RNA tests.