Anonymous HIV testing with participant-controlled access to results using handheld computers: a new model of HIV testing used in a household survey in rural South Africa.

摘要

Anonymous human immunodeficiency virus (HIV) surveys aim to provide unbiased estimates of HIV prevalence and are essential for monitoring the burden of HIV in a population. However, anonymous HIV surveys allow only limited linkage with risk factor data and do not allow participants to be informed of their HIV results. This is an important disadvantage in the face of evidence of individual and public health benefits of knowing one's HIV status and the increasing availability of anti-retroviral therapy worldwide. In accordance with ethical guidelines, anonymous HIV surveys usually refer participants to voluntary counseling and testing (VCT) services where these exist or else set up parallel VCT systems. This means that participants who wish to know their HIV status need to be bled and tested twice. Acceptance rates for such repeat VCT are not known.The World Health Organization (WHO) has recently called for initiatives to increase access to innovative, ethical, and practical models of HIV testing and counseling. We devised a novel approach to anonymous HIV testing which used handheld computer and encryption technology to allow participants in an HIV sero-survey to confidentially access their results. We describe this system of 'Linked Anonymous Testing with Participant-controlled Results' (LATPCR) and its operational use in a very large household HIV survey in rural South Africa.