Accuracy and User-Acceptability of HIV Self-Testing Using an Oral Fluid-Based HIV Rapid Test

10.1371/journal.pone.0045168PLoS ONE79

Opt-out of Voluntary HIV Testing: A Singapore Hospital's Experience

INTRODUCTION: Since 2008, the Singapore Ministry of Health (MOH) has expanded HIV testing by increasing anonymous HIV test sites, as well as issuing a directive to hospitals to offer routine voluntary opt out inpatient HIV testing. We reviewed this program implemented at the end of 2008 at Tan Tock Seng Hospital (TTSH), the second largest acute care general hospital in Singapore. METHODS AND FINDINGS: From January 2009 to December 2010, all inpatients aged greater or equal than 21 years were screened for HIV unless they declined or were not eligible for screening. We reviewed the implementation of the Opt Out testing policy. There were a total of 93,211 admissions; 41,543 patients were included based on HIV screening program eligibility criteria. Among those included, 79% (n = 32,675) opted out of HIV screening. The overall acceptance rate was 21%. Majority of eligible patients who were tested (63%) were men. The mean age of tested patients was 52 years. The opt out rate was significantly higher among females (OR: 1.5, 95%CI: 1.4-1.6), aged >60 years (OR: 2.3, 95%CI: 2.2-2.4) and Chinese ethnicity (OR: 1.7, 95%CI:1.6-1.8). The false positive rate of the HIV screening test is 0.56%. The proportion of patients with HIV infection among those who underwent HIV screening is 0.18%. All 16 confirmed HIV patients were linked to care. CONCLUSION: The default opt-in rate of inpatient HIV testing was low at Tan Tock Seng Hospital, Singapore. Efforts to address individual HIV risk perception and campaigns against HIV stigma are needed to encourage more individuals to be tested for HIV

Innovative and New Approaches to Laboratory Diagnosis of Zika and Dengue: A Meeting Report.

Epidemics of dengue, Zika, and other arboviral diseases are increasing in frequency and severity. Current efforts to rapidly identify and manage these epidemics are limited by the short diagnostic window in acute infection, the extensive serologic cross-reactivity among flaviviruses, and the lack of point-of-care diagnostic tools to detect these viral species in primary care settings. The Partnership for Dengue Control organized a workshop to review the current landscape of Flavivirus diagnostic tools, identified current gaps, and developed strategies to accelerate the adoption of promising novel technologies into national programs. The rate-limiting step to bringing new diagnostic tools to the market is access to reference materials and well-characterized clinical samples to facilitate performance evaluation. We suggest the creation of an international laboratory-response consortium for flaviviruses with a decentralized biobank of well-characterized samples to facilitate assay validation. Access to proficiency panels are needed to ensure quality control, in additional to in-country capacity building

Comparison of various HIV screening tests conducted in Singapore.

<p>A : January 2007 to December 2007: Action For AIDS (AFA)- Anonymous Testing Site⁶ : [MSM-5.7%, Heterosexual male-0.8%, Heterosexual female- 0.4%].</p><p>B: January 2009 to December 2010.</p><p>TTSH- Routine Voluntary Opt Out Inpatient HIV testing Program (This study).</p><p>C: January 2010 to December 2010 to Antenatal Screening From acute public hospitals and polyclinics (Data from Communicable Disease Division, MOH, Singapore 2010).</p

Characteristics of HIV Patients diagnosed through Screening Program.

∧<p>Medical comorbidities include: hypertension, diabetes, hyperlipidemia, coronary artery disease, depression, gout, benign prostatic hyperplasia, chronic hepatitis B, alcoholic liver disease.</p>∧∧<p>Not indicated to receive antiretroviral therapy based on current WHO HIV treatment guidelines.</p

Data on Total Admissions and Opt Out Voluntary HIV Testing (January 1, 2009 to December 31, 2010).

<p>Data on Total Admissions and Opt Out Voluntary HIV Testing (January 1, 2009 to December 31, 2010).</p

Reasons cited for opting out of HIV Screening Test.

*<p> <b>Other reasons cited include: fear of results, family objected, wants to resolve current medical illness first, deemed low risk.</b></p

Pilforter, Inc.

PILFORTER Incorporated was organized by ten students taking up Business Management under entrepreneurship program at De La Salle University. The company\u27s address is #30 Morning Star Drive, Sanville Subdivision, Diliman Quezon City. The corporation provides product which is convenient and practical. The idea of Pilforter which is a throw pillow and comforter in one rooted from the objective of the corporation which is providing unique and economical product. The proposed product is a throw pillow and comforter in one. Basically, it is a throw pillow which upon unzipping its sides, will be converted to a comforter. It is made of soft cotton cloth, which comes in different styles, fiberfill and zipper. It comes in three different shapes namely square, rectangle and hotdog shape. In its expanded form, it measures 43 x 51 1/2 . It weighs approximately 250 grams. The size and weight of the product make it more convenient. The product is also less bulky therefore it can save space. Aside from that, the proponents believe that coming up with such product will mean maximization of raw materials. Instead of using separate materials for comforter and pillow, Pilforter uses one for both purposes. It also maximizes the purchasing power of the people since the price is affordable. Previous practicum group, the PILO Incorporation, was able to sell 260 units of their product. The proponents also believe that they will be able to sell if more than or equal to 260 units. To support that, the potential demand for product was strengthened by the survey results, which reflected a market share of 11.25%. The gross market acceptability rate (GMAR) of 82% in the hypothesis testing implies that the number of respondents that are willing to buy product is significant. Households and students (especially those who live in dormitories) are the target markets of the company. The pricing system of the Pilforter was established based on the total cost per unit of the product which is P 327.52 with a mark up of P 72.05 or 22%. It will be sold at P 400.00 per unit. This is known as the cost-plus pricing method. The product will be made available through bazaars and retail outlets. Personal selling will also be adopted. The promotional items that will be utilized by the group are the following: flyers, calling cards and free gift items. The proponents acquired enough skills through practice and time and motion study. They have the ability and the capacity to manufacture Pilforter. The minimum production capacity per day is 5 units. On the other hand, the maximum unit to be produced per production day is 13 units. Thus, the average capacity is 9 units per production day