Experts decry HIV
test's lack of use

Nearly three years after a much-heralded HIV test uncovered an outbreak among black male college students in North Carolina, the test is still not being widely used--a delay some experts blame on government foot-dragging. Government officials said they are not yet endorsing the test because more studies need to be conducted before they are convinced of its effectiveness. The Centers for Disease Control and Prevention announced plans this week to study the test, called NAAT, in two upcoming trials. "The questions are hard questions. The only way to answer them is to evaluate it," said Bernard Branson, associate director for lab diagnostics for the CDC's National Center for HIV, STD, and TB Prevention. NAAT--Nucleic Acid Amplification Test--provides a new weapon for HIV experts. It was the main reason North Carolina health officials, who developed the test, were able to uncover an outbreak of the AIDS virus among 84 students at 37 colleges in the state. Conventional tests hunt for HIV by looking for antibodies. But these can take weeks to develop in the bloodstream, meaning a recently infected person would test negative. The NAAT test, by contrast, finds the actual virus itself and can do so within a week after infection. Because the test is expensive, it is done using blood pooling: Up to 100 samples that tested negative using antibody tests are pooled together and tested at once. If the virus is not found in the pooled sample, officials go no further. If the virus is found, individual samples are tested until the positive match is found. NAAT has increased HIV detection by 4% in North Carolina and 8% in San Francisco, where it has been used since 2003. Nonetheless, few places use the test, mainly because many health officials are waiting for the CDC to endorse it. Some experts said the time to use the test is now. "We can't wait for the CDC to do anything--it's up to localities to take the initiative," said Jeffrey Klausner, San Francisco's director of sexually transmitted disease prevention. "I would love to see strong evidence, but we often have to act and implement control efforts before we have the highest level of evidence." (AP)