Out In The Mountains : News - CARES Launches Quick HIV Test

      Burlington – As of December 5, anyone seeking an HIV test at Vermont CARES will have the option of getting their results back in 20 minutes. The old state-provided test requires samples to make a round-trip to the Department of Health with a two-week turnaround time for results to get to the consumer.
       "This is huge!" declared CARES Executive Director Peter Jacobsen. "This will eliminate people's anxiety over the two-week wait. Many, many more people will get tested."
      Jacobsen estimated that in the 2006 calendar year, the agency's testing sites would administer 1200 tests, compared to 800 for 2005.
      Jacobsen's assertion of a major increase was based on a pilot project conducted at Maple Leaf Farm in Jericho, a substance abuse treatment center. In a normal session, six people ask for an HIV test, Jacobsen said. During the pilot project for OraQuick, three times that many asked to be tested.
       About a third of people tested with the long-wait process never return for their results, according to national figures from the CDC. In Vermont, the Department of Health pays testing agencies for administering the tests only when its lab results are actually delivered, so absentee consumers put sexual partners at risk for infection and cost agencies money.
       The DoH has refused to use the new OraQuick test, contending that it will result in a high rate of false positives. The oral rapid test has been approved by the federal Food and Drug Administra-tion since March of 2004.
       According to Jacobsen, the results from the OraQuick test show only one in 1,000 come back as a false positive. "We always tell people that this is a preliminary test. But in the meantime, 999 people are getting correct results in 20 minutes." Anyone who tests positive is encouraged to get retested using the lab-based process.
        "We started a year ago having a dialogue with the Department of Health," Jacobsen said, "and then we realized we had to go on our own, we had to find private funding."
       The private funding is part of the agency's regular fundraising. No HIV-testing sugar daddy or mama has materialized to underwrite the program. Thus, anyone wanting the OraQuick results-in-20-minutes test will be asked to make a donation of around $40. The exceptions include prisoners and substance abuse treatment clients, whose tests are funded by a specific grant.
       "Because the rapid test is privately funded, we don't have to share the intrusive [client] data required by the CDC," Jacobsen pointed out, although the agency will share basic data on numbers of tests and results.
       Jacobsen expressed gratitude to Fletcher Allen Health Care in Burlington for a preliminary grant that helped to fund training, planning, and the pilot project.
        "This is crucial for the people we serve who are high risk and the most rural population, where getting back to get results can be nearly impossible," Jacobsen said. "Inmates can be transferred, substance abuse treatment patients rarely come back for results on the long test. Overall, the return rates for our Burlington site are 96 percent. The corrections and substance abuse treatment return rate is 40 to 60 percent, depending on the center or the facility."
       The test involves a swab of the upper and lower outer gums for "oral mucosal transudate" (loosely speaking, saliva). And at this point, said Jacobsen, "we always have to remind everyone that HIV cannot be transmitted through saliva." The results indicate whether antibodies to the virus are present. The test can also read a drop of blood from a finger stick, according to information provided by OraSure Technologies, Inc., the maker of the OraQuick test.
       "This is such crucial technology," Jacobsen said excitedly, "and it's already being used almost everywhere else in the country."
       CARES is the first agency in Vermont to use the OraQuick test, with the exception of a rapid-result blood test used at Fletcher Allen for occupational exposures.