Saliva Testing as a Practical Tool for Rapid HIV Screening

Abstract

Whilst the annual number of new HIV infections is steadily declining, levels of new infections overall are high and the number of people living with HIV has increased worldwide. An estimated 73,000 people in the UK are living with HIV, of which it is estimated that 24,000 are undiagnosed or unaware of their HIV status (Health Protection Agency, 2007). The prevalence of undiagnosed HIV infection would therefore seem a key driver for increased and routine HIV testing, both to lessen the potential for unwitting transmission of HIV and to support early detection and timely access to medical care in those infected. It has been shown that late diagnosis of HIV infection, resulting in delayed patient management, is associated with poorer survival (Losina et al., 2009). In the UK, the National Strategy for Sexual Health and HIV (Department of Health, 2001) aims to reduce the prevalence of undiagnosed HIV by increasing screening. This is a rapidly advancing field and whilst it is beyond the scope of this chapter to encapsulate all the current evidence in this field, a brief overview is presented of saliva testing as a diagnostic tool, the benefits and the caveats. The contexts in which saliva testing for HIV are currently conducted is considered both in the UK and internationally. The evidence for the sensitivity and specificity of this method will be considered. Attitudes of recipients towards rapid HIV screening, in particular saliva testing, are considered together with attitudes towards the contexts in which testing is undertaken.