New HIV testing strategies: Supply chain implications

Issues

New strategies to expand access to HIV Testing and Counseling (HTC) focus on reaching those who do not suspect they may be infected and symptomatic individuals already accessing health facilities. Facility-based PITC expands HTC to in-patient wards, out-patient departments, TB and STI clinics. Non-facility based initiatives include deployment of mobile units and door-to-door testing. A reliable supply of HIV tests is critical to the success of these strategies.

Description

Overall demand of HIV tests will increase. Quantification of HIV tests and costs to meet the surge in demand through these new strategies should also include the following considerations:

• HIV testing algorithms

• Quantities of HIV tests needed to comply with quality control procedures

• Higher HIV prevalence of symptomatic individuals detected through PITC requires larger quantities of confirmatory tests if using a serial testing algorithm

• As community based testing increases, this population will have a lower HIV prevalence, resulting in the need for fewer confirmatory tests

• Given conditions under which testing is performed in non-facility based settings, more tiebreaker tests may be needed for re-testing of discordant results

• A broader range of health care workers to provide PITC and non-facility based testing requires greater quantities of HIV tests for training

Recommendation

While the overall demand for HIV tests will rise with implementation of new HIV testing strategies, the quantities of each test needed will vary based on the testing algorithm, the populations being tested, and the quantities of tests needed for training and quality control.