The health outreach project for HIV/AIDS testing comprised one of the upgrade and life quality improvement projects for Magazine Squatter Compound in Chipata District, Zambia. Although HIV/AIDS awareness and sensitization has been conducted in the Compound before, HIV/AIDS testing has not been regularly performed. The Corridors of Hope (Chipata Branch), a partner of USAID and the Ministry of Health of Zambia, assisted the social planning division of the Department of Planning and Information of the Chipata Municipal Council with performing the tests.
The first testing outreach session was held on 10 January, 2012 in the Magazine Squatter Compound marketplace.
The State of HIV/AIDS in Zambia
Although Chipata District is not considered an area with a high HIV/AIDS rate, the population is changing and many migrants are moving to accept employment offers or to start businesses in the district. Many of these migrants are arriving from the Central Province and Lusaka, where HIV/AIDS rates are at their highest.
According to AVERT, an HIV/AIDS charity based in the United Kingdom, the rate of HIV/AIDS has more than doubled since the first reported case was broadcast in 1984. By the early 1990s, one in five persons had contracted the virus.
Women are reported to be especially vulnerable because of their subordinate status. A discussion with a local Zambian resident revealed the lack of voice women have in their marital relationships. This resident explained that social customs pressure the woman to comply with the man’s wishes; she cannot contradict him, and this includes sexual relationships.
Children and young adults are also vulnerable demographics. Among young women of 15 to 24 years, the prevalence of the virus is especially high. Among children, about 120,000 are infected; the stigma of HIV/AIDS and the vulnerability of young children causes them to become orphans. AVERT claims that as many as 690,000 children were orphaned in 2009.
Applying the HIV/AIDS Rapid Testing Kit to Magazine Squatter Compound
The Corridors of Hope uses a three step rapid testing kit to ensure accuracy of blood test results. Although blood is still the determinant for the presence of antibodies, the Alere Determine HIV 1 test kit, the initial step of a three phase immunoassay testing process, is able to detect the onset of HIV and takes only 15 minutes to determine if an individual is HIV positive.
A cotton swab is brushed across the thumb. A quick prick of the thumb, using a tiny disposable needle, draws drops of blood, which is brushed against the white stripe on the Determine test kit. The strip draws the blood across the “patient” window and the “control” window. If a thin, faint line shows up in both windows, the individual is considered HIV positive; if the same faint line emerges only in the “control” window, the individual is considered HIV non-reactive.
The Alere Determine is used in combination with the Abbott test. Those demonstrating an HIV positive result on the Determine HIV 1 test are given Viramune, an inhibitor, before being referred to the second phase, the Abbott HIV 2 test.
If there is a contradiction in the results, individuals are referred to another test, the Uni-Gold Recombigen HIV, to determine the accuracy of the first two tests. Labeled by Corridors of Hope as the "tie-breaker", the Uni-Gold HIV is more complicated. It requires light, must be performed in a room of temperatures between 59 and 80.6 degrees Fahrenheit, and must be read within a strict 10 to 12 minute incubation period. The incubation period must be timed, perfectly.
The blood sample, after being collected with a pipette, is dropped in the sample port; the results are read in the test line and the control line areas.
Faint lines in both areas signify HIV positive results.
What makes this combination of tests unique from other rapid tests is early detection. The Alere Determine detects the p24 antigen (Ag) within a three week period after contraction of HIV, and prior to the production of antibodies (Ab). In comparison, Oraquick (another portable rapid test kit) has a three-month window period. Early detection for HIV/AIDS is key to preventing the spread of it and to medicating.
Conclusion
This combination of HIV/AIDS immunoassay tests is increasingly being used in developing countries for their ease of use and their accuracy. It is recommended by USAID and has been confirmed by scholars to be highly sensitive, referring to the tests’ accuracy.
The HIV/AIDS testing program is expected to be applied to the five other squatter compounds around Chipata District as part of the Corridors of Hope's regular routine, pending funds.
Sources:
- Alere Determine. Website. Inverness Medical <http://www.determinetest.com/> accessed 11 January, 2012.
- Avert, International HIV & AIDS Charity. Website. <http://www.avert.org/aids-zambia.htm#contentTable0> accessed 11 January, 2012.
- Chipata resident, Ngoni Zambian, SPAR Supermarket, 29 June, 2011.
- Corridors of Hope, Tester and Counselor, Magazine Squatter Compound, 11 January 2012.
- Jeffrey L. Greenwald, MD, Gale R. Burstein, MD, MPH, FAAP, Jonathan Pincus, MD, and Bernard Branson, MD. “A Rapid Review of Rapid HIV Antibody Tests”. Current Science: Current Infectious Disease Reports, 2006 8: 125-31.
- Trinity Bio-tech. “Quick Reference Guide for Uni-Gold Recombigen HIV”. <http://www.unigoldhiv.com/unigold_quickref.pdf>. accessed 11 January, 2012.
- USAID, “HIV/AIDS Rapid Test Kits: Process for USAID Approval and Technical Guidance”, USAID, 5 March 2010. accessed 11 January, 2012.
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