HIV surveillance in a large, community-based study: results from the pilot study of Project Accept (HIV prevention trials network 043)

This study provides information on the accuracy of HIV surveillance testing performed in the context of a clinical trial, where testing was performed in local laboratories in Thailand, Tanzania, Zimbabwe and South Africa. In-country testing based on two HIV rapid tests correctly identified the HIV infection status for 99.5% of study participants; most participants with discordant HIV rapid tests were not infected. HIV prevalence varied considerably across the five Project Accept study sites (range: 0.6% to 25.4%). Further studies are needed to assess the accuracy of HIV testing in surveillance and clinical programs where testing is performed in non laboratory (e.g., home-based) settings. Further research is also needed to identify and validate robust, accurate methods for cross-sectional HIV incidence determination that could easily be incorporated into HIV surveillance programs.