Shelley Facente, MPH and Teri Dowling, MA, MPH.
San Francisco Department of Public Health, AIDS Office, HIV Prevention Section.
Issues: Implementation of rapid HIV testing programs that are acceptable to the laboratory community, feasible for health departments and/or community-based organizations (CBOs), and provide high quality client services can be challenging to implement. This presentation addresses lessons learned for implementation of such programs, as well as recommendations for comprehensive systems of quality assurance.
Description: The San Francisco Department of Public Health works with subcontracted CBOs to design, implement, and continually assess rapid HIV testing programs. This has been successful, despite initial resistance from lab personnel and agency staff. Quality assurance efforts have intensified as both the number and maturity of rapid testing programs have increased.
Lessons Learned: Working closely with laboratory policymakers to design and implement rapid testing protocols is key to successful implementation. This also leads to greater integrity in lab practices, especially important for social service agencies, whose work usually requires less attention to detail. Early clarity about expectations for data and program quality prevents problems with quality assurance later.
Recommendations: Speak directly with lab personnel, asking what would increase their confidence in the proposed rapid testing program, and then act upon those suggestions. Plan carefully, train well, and begin slowly. Determine a system for data monitoring, including elements prone to human error, such as the time and temperature under which the test is conducted, or the use of controls to ensure test kit functionality. Work closely with those individuals actively providing rapid testing services, to be sure that proposed procedures will be feasible in practice.

Last Update: April 8, 2005