Feasibility and staff acceptability of implementing Xpert HIV-1 viral load point-of-care testing: a pilot study in San Francisco
Abstract Background Point-of-care HIV viral load testing may enhance patient care and improve HIV health services. We aimed to evaluate the feasibility and acceptability of implementing such testing in a high-volume community sexual health clinic in the United States. Methods We conducted a cross-se...
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2025-01-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-024-10384-2 |
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| author | Kelvin Moore Jr. Noelle Le Tourneau Jasmin Alvarez Santos Rodriguez Janessa Broussard Pierre-Cédric Crouch Jorge Roman Patricia Defechereux Jason Bena Kimberly A. Koester Lissa Moran Christopher Pilcher Robert Grant Katerina A. Christopoulos |
| author_facet | Kelvin Moore Jr. Noelle Le Tourneau Jasmin Alvarez Santos Rodriguez Janessa Broussard Pierre-Cédric Crouch Jorge Roman Patricia Defechereux Jason Bena Kimberly A. Koester Lissa Moran Christopher Pilcher Robert Grant Katerina A. Christopoulos |
| author_sort | Kelvin Moore Jr. |
| collection | DOAJ |
| description | Abstract Background Point-of-care HIV viral load testing may enhance patient care and improve HIV health services. We aimed to evaluate the feasibility and acceptability of implementing such testing in a high-volume community sexual health clinic in the United States. Methods We conducted a cross-sectional, mixed-methods study. Remnant venipuncture specimens from clients undergoing HIV and other sexual health screenings were analyzed using the Xpert® HIV-1 Viral Load assay. Results were compared to COBAS® AmpliPrep/COBAS® TaqMan® HIV-1 Test. Clinical staff observations, study meeting notes, and two semi-structured in-depth interviews with clinical staff were used to understand perspectives on incorporating this testing into clinical practice. Results We analyzed 113 samples from 111 clients. The Xpert assay showed excellent agreement with COBAS, with no clinically significant difference in viral load measurements. Clinical staff found Xpert testing acceptable, based on its ability to provide rapid, accurate test results and potential for bridging patient care gaps. Respondents noted that this testing would be particularly beneficial for individuals in whom barriers to care engagement may complicate follow-up. Challenges in implementation included machine errors as well as concerns related to staff workload, testing logistics, and the need for comprehensive equipment training. Conclusions This study represents the first effort in the United States to describe the feasibility of HIV viral load point-of-care testing in routine care. While the Xpert demonstrated comparable results to standard-of-care testing and staff found it acceptable, further work is needed to develop the workflow and implementation strategies that would enable real-time use and improved patient care. Clinical trial Not applicable. |
| format | Article |
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| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-015d67ac27c243dd9334bf8fb33b27d72025-01-12T12:09:48ZengBMCBMC Infectious Diseases1471-23342025-01-012511710.1186/s12879-024-10384-2Feasibility and staff acceptability of implementing Xpert HIV-1 viral load point-of-care testing: a pilot study in San FranciscoKelvin Moore Jr.0Noelle Le Tourneau1Jasmin Alvarez2Santos Rodriguez3Janessa Broussard4Pierre-Cédric Crouch5Jorge Roman6Patricia Defechereux7Jason Bena8Kimberly A. Koester9Lissa Moran10Christopher Pilcher11Robert Grant12Katerina A. Christopoulos13University of California, San FranciscoUniversity of California, San FranciscoSan Francisco AIDS FoundationSan Francisco AIDS FoundationUniversity of California, San FranciscoUniversity of California, San FranciscoUniversity of California, San FranciscoGladstone InstitutesSan Francisco AIDS FoundationUniversity of California, San FranciscoUniversity of California, San FranciscoUniversity of California, San FranciscoUniversity of California, San FranciscoUniversity of California, San FranciscoAbstract Background Point-of-care HIV viral load testing may enhance patient care and improve HIV health services. We aimed to evaluate the feasibility and acceptability of implementing such testing in a high-volume community sexual health clinic in the United States. Methods We conducted a cross-sectional, mixed-methods study. Remnant venipuncture specimens from clients undergoing HIV and other sexual health screenings were analyzed using the Xpert® HIV-1 Viral Load assay. Results were compared to COBAS® AmpliPrep/COBAS® TaqMan® HIV-1 Test. Clinical staff observations, study meeting notes, and two semi-structured in-depth interviews with clinical staff were used to understand perspectives on incorporating this testing into clinical practice. Results We analyzed 113 samples from 111 clients. The Xpert assay showed excellent agreement with COBAS, with no clinically significant difference in viral load measurements. Clinical staff found Xpert testing acceptable, based on its ability to provide rapid, accurate test results and potential for bridging patient care gaps. Respondents noted that this testing would be particularly beneficial for individuals in whom barriers to care engagement may complicate follow-up. Challenges in implementation included machine errors as well as concerns related to staff workload, testing logistics, and the need for comprehensive equipment training. Conclusions This study represents the first effort in the United States to describe the feasibility of HIV viral load point-of-care testing in routine care. While the Xpert demonstrated comparable results to standard-of-care testing and staff found it acceptable, further work is needed to develop the workflow and implementation strategies that would enable real-time use and improved patient care. Clinical trial Not applicable.https://doi.org/10.1186/s12879-024-10384-2HIVViral loadPoint-of-care testingAntiretroviral therapyAcute HIV infection |
| spellingShingle | Kelvin Moore Jr. Noelle Le Tourneau Jasmin Alvarez Santos Rodriguez Janessa Broussard Pierre-Cédric Crouch Jorge Roman Patricia Defechereux Jason Bena Kimberly A. Koester Lissa Moran Christopher Pilcher Robert Grant Katerina A. Christopoulos Feasibility and staff acceptability of implementing Xpert HIV-1 viral load point-of-care testing: a pilot study in San Francisco BMC Infectious Diseases HIV Viral load Point-of-care testing Antiretroviral therapy Acute HIV infection |
| title | Feasibility and staff acceptability of implementing Xpert HIV-1 viral load point-of-care testing: a pilot study in San Francisco |
| title_full | Feasibility and staff acceptability of implementing Xpert HIV-1 viral load point-of-care testing: a pilot study in San Francisco |
| title_fullStr | Feasibility and staff acceptability of implementing Xpert HIV-1 viral load point-of-care testing: a pilot study in San Francisco |
| title_full_unstemmed | Feasibility and staff acceptability of implementing Xpert HIV-1 viral load point-of-care testing: a pilot study in San Francisco |
| title_short | Feasibility and staff acceptability of implementing Xpert HIV-1 viral load point-of-care testing: a pilot study in San Francisco |
| title_sort | feasibility and staff acceptability of implementing xpert hiv 1 viral load point of care testing a pilot study in san francisco |
| topic | HIV Viral load Point-of-care testing Antiretroviral therapy Acute HIV infection |
| url | https://doi.org/10.1186/s12879-024-10384-2 |
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