Most people assume HIV testing involves blood. While blood is the most commonly used, saliva is an alternative specimen to test and diagnose HIV in adults and adolescents. Benefits of saliva-based testing include the ease of collecting samples and increased acceptability of HIV testing. One example of a saliva-based test is OraQuick, a device used to collect and rapidly test saliva.
The OraQuick test strip collects saliva from patients’ upper and lower gums, then is inserted into a tube to test for HIV. The saliva reacts to liquid in the tube and travels up the stick. If only the upper line appears, the test is negative. If both lines appear, the test is positive.
Saliva-based testing has produced very good results in adults; however, very few studies have evaluated this method among children Considering the ease of collecting saliva compared to drawing blood using a finger prick (ouch!), saliva-based testing is a good alternative for this population in need of early HIV testing, diagnosis, and care.
Last week, Global WACh and the University of Nairobi launched a new study to address this need. Led by Post-Doctoral Fellows, Drs. Anjuli Wagner and Irene Njuguna, the Saliva Testing and Video Information to Expand Uptake of Pediatric Testing (STEP-UP) project aims to validate the OraQuick test in children ages 18 months to 12 years old. The project will also develop and evaluate the effectiveness of video pre-test information session prior to HIV testing. Both strategies aim to increase pediatric HIV testing in outpatient clinics in Kenya, where high patient volumes make it difficult for healthcare staff to offer adequate HIV counseling to every client.
The STEP-UP study team completed a training to learn about OraQuick and how to perform the test. The team had a great time participating in team building exercises, practicing collecting saliva from one another, and ending the training with a team dinner. Check out photos below!
The STEP-UP study team from UW and the University of Nairobi
Lukio fills in questionnaire answers to a mobile data collection tool called Open Data Kit (ODK), while the OraQuick reaction is taking place in the background.
Tamasha practices using the OraQuick test kit, placing the test strip in the reaction fluid.
The study team will start recruiting participants this month in multiple clinics in Kisumu, Siaya, and Homa Bay counties in Kenya. They hope to test 1,050 children for HIV and the HIV video consultation in 150 participants. The team will also include a series of focus group discussion about patient and health care workers’ perceptions about using the OraQuick test and video consultation. The STEP-UP project is anticipated to end in August 2019.