**Module 9: Performing HIV Rapid Tests (Demo and Practice)**

+----------------+-----------------------------------------------------+
| **Purpose**    | To provide the participants with necessary          |
|                | knowledge and skills to accurately perform 3 HIV    |
|                | rapid tests and to determine HIV status.            |
+----------------+-----------------------------------------------------+
| **P            | -   Module 3: Overview of HIV Testing Technologies  |
| re-requisite** |                                                     |
|                | -   Module 4: HIV Testing Strategies & Algorithms   |
| **Modules**    |                                                     |
|                | -   Module 6: Safety at the HIV Rapid Testing Site  |
|                |                                                     |
|                | ```{=html}                                          |
|                | <!-- -->                                            |
|                | ```                                                 |
|                | -   Module 7: Preparation for Testing -- Supplies & |
|                |     Kits                                            |
|                |                                                     |
|                | -   Module 8: Blood Collection -- Fingerprick       |
+----------------+-----------------------------------------------------+
| **Module       | 5 ½ hours                                           |
| Time**         |                                                     |
+----------------+-----------------------------------------------------+
| **Learning     | At the end of this module, participants will be     |
| Objectives**   | able to:                                            |
|                |                                                     |
|                | -   Perform 3 HIV rapid tests according to Standard |
|                |     Operating Procedure (SOP)                       |
|                |                                                     |
|                | -   Perform multiple tests simultaneously           |
|                |                                                     |
|                | -   Accurately interpret individual test results    |
|                |                                                     |
|                | -   Accurately determine HIV status                 |
+----------------+-----------------------------------------------------+

**Module Overview**

+-----+-------+--------------+------------------+----------------------+
| **  | **T   | **Activity/\ | **Content**      | **Resources\         |
| Ste | ime** | Method**     |                  | Needed**             |
| p** |       |              |                  |                      |
+-----+-------+--------------+------------------+----------------------+
| **  | 5 min | >            | Module           | Slides 1-3           |
| 1** |       | Presentation | introduction     |                      |
+-----+-------+--------------+------------------+----------------------+
| **  | 15    | > P          | Slide overview   | Slides 4-36; dry     |
| 2** | min   | resentation; | of testing       | room                 |
|     |       | > Discussion | procedures       |                      |
|     |       |              |                  | One-pager job aids   |
+-----+-------+--------------+------------------+----------------------+
| **  | 10    | > Activity   | Workspace setup  | Slide 37; practical  |
| 3** | min   |              |                  | room; supplies &     |
|     |       |              |                  | test kits            |
+-----+-------+--------------+------------------+----------------------+
| *   |       |              |                  |                      |
| *St |       |              |                  |                      |
| eps |       |              |                  |                      |
| 4 & |       |              |                  |                      |
| 5   |       |              |                  |                      |
| are |       |              |                  |                      |
| c   |       |              |                  |                      |
| onc |       |              |                  |                      |
| urr |       |              |                  |                      |
| ent |       |              |                  |                      |
| ses |       |              |                  |                      |
| sio |       |              |                  |                      |
| ns. |       |              |                  |                      |
| Par |       |              |                  |                      |
| tic |       |              |                  |                      |
| ipa |       |              |                  |                      |
| nts |       |              |                  |                      |
| are |       |              |                  |                      |
| d   |       |              |                  |                      |
| ivi |       |              |                  |                      |
| ded |       |              |                  |                      |
| i   |       |              |                  |                      |
| nto |       |              |                  |                      |
| 2   |       |              |                  |                      |
| gro |       |              |                  |                      |
| ups |       |              |                  |                      |
| and |       |              |                  |                      |
| t   |       |              |                  |                      |
| ake |       |              |                  |                      |
| tu  |       |              |                  |                      |
| rns |       |              |                  |                      |
| p   |       |              |                  |                      |
| art |       |              |                  |                      |
| ici |       |              |                  |                      |
| pat |       |              |                  |                      |
| ing |       |              |                  |                      |
| in  |       |              |                  |                      |
| s   |       |              |                  |                      |
| tep |       |              |                  |                      |
| 4   |       |              |                  |                      |
| and |       |              |                  |                      |
| S   |       |              |                  |                      |
| tep |       |              |                  |                      |
| 5   |       |              |                  |                      |
| .** |       |              |                  |                      |
+-----+-------+--------------+------------------+----------------------+
| **  | 1 hr  | > Demo &     | HIV rapid tests  | Slide 38; practical  |
| 4** |       | > practice   |                  | room; supplies &     |
|     | 15    |              |                  | test kits; known     |
|     | min   |              |                  | samples              |
+-----+-------+--------------+------------------+----------------------+
| **  | 1 hr  | > P          | Video review of  | Slides 39-44;        |
| 5** |       | resentation; | testing          |                      |
|     | 15    | > Discussion | procedures       | videotape; dry room  |
|     | min   |              |                  |                      |
+-----+-------+--------------+------------------+----------------------+
| **  |       |              |                  |                      |
| End |       |              |                  |                      |
| of  |       |              |                  |                      |
| c   |       |              |                  |                      |
| onc |       |              |                  |                      |
| urr |       |              |                  |                      |
| ent |       |              |                  |                      |
| s   |       |              |                  |                      |
| ess |       |              |                  |                      |
| ion |       |              |                  |                      |
| s** |       |              |                  |                      |
+-----+-------+--------------+------------------+----------------------+
| **  | 10    | > P          | Video overview   | Slides 45-47;        |
| 6** | min   | resentation; | of multi-test    | videotape; dry room  |
|     |       | >            | algorithm        |                      |
|     |       | > Discussion |                  |                      |
+-----+-------+--------------+------------------+----------------------+
| **  | 2 hrs | > Practice   | Conducting       | Slides 48-49;        |
| 7** |       |              | multiple HIV     | supplies & test      |
|     | 15    |              | rapid tests      | kits; panels of      |
|     | min   |              |                  | samples;             |
|     |       |              |                  |                      |
|     |       |              |                  | practical room       |
+-----+-------+--------------+------------------+----------------------+
| **  | 5 min | > Q&A        | Summary          | Slide 50             |
| 8** |       |              |                  |                      |
+-----+-------+--------------+------------------+----------------------+

**Material/Equipment Checklists**

-   PowerPoint slides or transparencies

-   Overhead projector or computer w/LCD projector

-   Prepared Flipchart -- content outline

-   Video and equipment to play the video

-   Materials, supplies, and test kits required for rapid testing. Refer
    to [Section 2: Preparation]{.underline} for quantities needed.

-   Panels of blood samples for testing. Refer to [Section 2:
    Preparation]{.underline} for quantities needed and preparation
    guidance.

-   One-pager job aids for HIV rapid tests

-   Handouts:

    -   Job Aids for the tests in your country's testing algorithm

    -   Video script for HIV rapid tests

    -   [Practical exercise recording worksheet]{.underline}

**Advanced Preparation**

-   Review Section 2 of Trainer's Guide -- Materials, Supplies, Kits,
    and Panels.

-   Setup trainer Workspace with necessary supplies and kits.

-   To better manage the space and facilitate learning, you will need 2
    rooms:

```{=html}
<!-- -->
```
-   Room A -- a dry or clean room for presentation

-   Room B -- a practical room for demo and practice.

**Teaching Guide**

+-----------------+-----------------------------------------------------+
| **Slide         | **Teaching Points**                                 |
| Number**        |                                                     |
+=================+=====================================================+
| **1**           | **[Module 9: Performing HIV Rapid Tests             |
|                 | (Demonstration and Practice)]{.underline}**         |
|                 |                                                     |
|                 | DISPLAY this slide before you begin the module.     |
|                 | Make sure participants are aware of the transition  |
|                 | into a new module.                                  |
+-----------------+-----------------------------------------------------+
| **2**           | **[Learning Objectives]{.underline}**               |
|                 |                                                     |
|                 | STATE the objectives on the slide.                  |
|                 |                                                     |
|                 | STATE that the three HIV rapid test kits that we're |
|                 | going to demonstrate today are the ones included in |
|                 | the country algorithm; the screening test (*name of |
|                 | test*), confirmation test (*name of test*) and      |
|                 | tiebreaker test *(name of test*).                   |
+-----------------+-----------------------------------------------------+
| **3**           | **[Content Overview]{.underline}**                  |
|                 |                                                     |
|                 | EXPLAIN the process and logistics of this module.   |
|                 |                                                     |
|                 | -   Two rooms have been set up: a dry room for      |
|                 |     presentation and a practical room for           |
|                 |     demonstration and hands-on practice.            |
|                 |                                                     |
|                 | -   All participants will watch a presentation      |
|                 |     together to learn the procedures for three HIV  |
|                 |     rapid tests. This will take place in the room   |
|                 |     they are currently in, the dry room (A).        |
|                 |                                                     |
|                 | ```{=html}                                          |
|                 | <!-- -->                                            |
|                 | ```                                                 |
|                 | -   They will then all move to the practical        |
|                 |     room (B) to setup their work stations.          |
|                 |                                                     |
|                 | -   Then the participants will split into two       |
|                 |     groups.                                         |
|                 |                                                     |
|                 | ```{=html}                                          |
|                 | <!-- -->                                            |
|                 | ```                                                 |
|                 | -   Group I will stay in Room B for demo and        |
|                 |     hands-on practice. This group will learn the    |
|                 |     individual tests with known samples.            |
|                 |                                                     |
|                 | -   Group II will go back to Room A to watch video  |
|                 |     and review the testing procedures.              |
|                 |                                                     |
|                 | ```{=html}                                          |
|                 | <!-- -->                                            |
|                 | ```                                                 |
|                 | -   Then these two groups will switch.              |
|                 |                                                     |
|                 | -   After a break, briefly convene the participants |
|                 |     in the dry room for the Multiple HIV Tests      |
|                 |     video and slide presentation to prepare for the |
|                 |     next practice session.                          |
|                 |                                                     |
|                 | -   Then all participants will go to the practical  |
|                 |     room (B) to practice multi-test algorithm using |
|                 |     blind samples.                                  |
+-----------------+-----------------------------------------------------+
|                 | ANNOUNCE that there will be a one-hour optional     |
|                 | hands-on session for participants who wish for      |
|                 | additional help or more practice. It will be        |
|                 | offered at (insert time, could be at a lunch break  |
|                 | or at the end of a day)                             |
+-----------------+-----------------------------------------------------+
| **F             | WRITE the content outline on a flipchart prior to   |
| lipchart**![](m | training.                                           |
| edia/image1.wmf |                                                     |
| ){width="0.8423 | REFER to it frequently to orient participants to    |
| 611111111111in" | where they are in the module.                       |
| height="0.84236 |                                                     |
| 11111111111in"} |                                                     |
+-----------------+-----------------------------------------------------+
| **Slide         |                                                     |
| overview of the |                                                     |
| test procedures |                                                     |
| (Room A)**      |                                                     |
+-----------------+-----------------------------------------------------+
| ![](me          | Instructions for five tests are provided here for   |
| dia/image2.wmf) | reference purpose only. Refer to only those slides  |
| {width="0.49166 | that are part of the country algorithm and will be  |
| 666666666664in" | taught in the workshop.                             |
| heigh           |                                                     |
| t="0.4416666666 | -   Capillus (slides \# 4-10)                       |
| 6666665in"}***C |                                                     |
| ustomization*** | ```{=html}                                          |
|                 | <!-- -->                                            |
| ***Notes***     | ```                                                 |
|                 | -   Determine (slides \# 11-16)                     |
| **4-36**        |                                                     |
|                 | ```{=html}                                          |
|                 | <!-- -->                                            |
|                 | ```                                                 |
|                 | -   Hema-Strip (slides \# 17-23)                    |
|                 |                                                     |
|                 | -   OraQuick (slides \# 24-30)                      |
|                 |                                                     |
|                 | -   Uni-Gold (slides \# 31-36)                      |
+-----------------+-----------------------------------------------------+
| ![](me          | If your country uses tests not included in this     |
| dia/image2.wmf) | material, you may still model after the teaching    |
| {width="0.49166 | methodology here to teach those tests. Pay          |
| 666666666664in" | attention to:                                       |
| heigh           |                                                     |
| t="0.4416666666 | -   The sequence of instructional events            |
| 6666665in"}***C |                                                     |
| ustomization*** | ```{=html}                                          |
|                 | <!-- -->                                            |
| ***Notes***     | ```                                                 |
|                 | -   How test demonstration is conducted             |
|                 |                                                     |
|                 | ```{=html}                                          |
|                 | <!-- -->                                            |
|                 | ```                                                 |
|                 | -   How hands-on practice is conducted (including   |
|                 |     specimens provided for the practice)            |
|                 |                                                     |
|                 | -   How video is presented                          |
+-----------------+-----------------------------------------------------+
| **4**           | **[Capillus]{.underline}**                          |
|                 |                                                     |
|                 | INFORM the participants that the next few slides    |
|                 | address the test procedure for Capillus.            |
+-----------------+-----------------------------------------------------+
| **5**           | **[Capillus: Getting Ready]{.underline}**           |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | -   Use a permanent marker to label test with       |
|                 |     client's ID                                     |
+-----------------+-----------------------------------------------------+
| **6**           | **[Capillus: Reagent Preparation]{.underline}**     |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | Add the following information for Step 4:           |
|                 |                                                     |
|                 | -   It is important to gently mix reagent.          |
|                 |                                                     |
|                 | -   Vigorously shaking will result in air bubbles,  |
|                 |     which make it difficult to dispense the correct |
|                 |     amount in the next step.                        |
+-----------------+-----------------------------------------------------+
| **7**           | **[Capillus: Collecting Specimen]{.underline}**     |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | ADD the following points:                           |
|                 |                                                     |
|                 | -   The pre-calibrated pipette is included with the |
|                 |     kit.                                            |
|                 |                                                     |
|                 | -   The pipette is set to collect 10µl**.**         |
+-----------------+-----------------------------------------------------+
| **8**           | **[Capillus: Applying Specimen to Test              |
|                 | Slide]{.underline}**                                |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
+-----------------+-----------------------------------------------------+
| **9**           | **[Capillus: Getting Results]{.underline}**         |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | ADD the following information for Step 11:          |
|                 |                                                     |
|                 | -   If a timer is not available, use your watch or  |
|                 |     clock on the wall to monitor the time.          |
|                 |                                                     |
|                 | -   It is a good practice to write down the         |
|                 |     starting time or projected end time to help you |
|                 |     keep track of time.                             |
|                 |                                                     |
|                 | ADD the following information for Step 12:          |
|                 |                                                     |
|                 | -   In addition to test results, the tester should  |
|                 |     also record on appropriate forms the following  |
|                 |     information:                                    |
|                 |                                                     |
|                 |     -   The test date                               |
|                 |                                                     |
|                 |     -   Client identification                       |
|                 |                                                     |
|                 |     -   Name of the person performing the test      |
|                 |                                                     |
|                 |     -   The name of the test                        |
|                 |                                                     |
|                 |     -   The expiration date                         |
|                 |                                                     |
|                 |     -   Test lot number                             |
|                 |                                                     |
|                 |     -   Control lot number                          |
+-----------------+-----------------------------------------------------+
| **10**          | **[Capillus: Test Interpretation]{.underline}**     |
|                 |                                                     |
|                 | REMIND the participants how to read the Capillus    |
|                 | results.                                            |
|                 |                                                     |
|                 | -   There are two possible test results, reactive   |
|                 |     or non-reactive.                                |
|                 |                                                     |
|                 | -   Capillus does not have an internal control      |
|                 |     line.                                           |
+-----------------+-----------------------------------------------------+
| **11**          | **[Determine]{.underline}**                         |
|                 |                                                     |
|                 | INFORM the participants that the next few slides    |
|                 | address the test procedure for Determine.           |
+-----------------+-----------------------------------------------------+
| **12**          | **[Determine: Reagent Preparation]{.underline}**    |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | -   Remember to have on hand the chase buffer       |
|                 |     because it is not included in the kit.          |
|                 |                                                     |
|                 | -   When tearing off one test strip it is easier if |
|                 |     you bend the unopened strip back and forth,     |
|                 |     then tear the strip away from the others.       |
|                 |                                                     |
|                 | -   Once the test strip is opened, do not touch the |
|                 |     testing area.                                   |
+-----------------+-----------------------------------------------------+
| **13**          | **[Determine: Collecting Specimen]{.underline}**    |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
+-----------------+-----------------------------------------------------+
| **14**          | **[Determine: Applying Specimen and Buffer to Test  |
|                 | Strip]{.underline}**                                |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | ADD the following information for Step 7:           |
|                 |                                                     |
|                 | -   Check to see that the sample is moving along    |
|                 |     the test strip -- this will take a moment.      |
|                 |                                                     |
|                 | -   If not, add one more drop of buffer to the      |
|                 |     strip.                                          |
|                 |                                                     |
|                 | -   But, do not waste buffer.                       |
+-----------------+-----------------------------------------------------+
| **15**          | **[Determine: Getting Results]{.underline}**        |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | ADD the following information for Step 8:           |
|                 |                                                     |
|                 | -   If a timer is not available, use your watch or  |
|                 |     clock on the wall to monitor the time.          |
|                 |                                                     |
|                 | -   It is a good practice to write down the         |
|                 |     starting time or projected end time to help you |
|                 |     keep track of time.                             |
|                 |                                                     |
|                 | ADD the following information for Step 9:           |
|                 |                                                     |
|                 | -   In addition to test results, the tester should  |
|                 |     also record on appropriate forms the following  |
|                 |     information:                                    |
|                 |                                                     |
|                 |     -   The test date                               |
|                 |                                                     |
|                 |     -   Client identification                       |
|                 |                                                     |
|                 |     -   Name of the person performing the test      |
|                 |                                                     |
|                 |     -   The name of test                            |
|                 |                                                     |
|                 |     -   The expiration date                         |
|                 |                                                     |
|                 |     -   Test lot number                             |
|                 |                                                     |
|                 |     -   Control lot number                          |
+-----------------+-----------------------------------------------------+
| **16**          | **[Determine: Test Interpretation]{.underline}**    |
|                 |                                                     |
|                 | REMIND the participants how to read the Determine   |
|                 | results.                                            |
|                 |                                                     |
|                 | -   There are three possible test results:          |
|                 |     reactive, non-reactive, and invalid.            |
|                 |                                                     |
|                 | -   Any visible line in the patient/client window   |
|                 |     should be read as reactive, when the control    |
|                 |     line is also visible.                           |
|                 |                                                     |
|                 | -   Note: A shadow may be seen, but this is not to  |
|                 |     be understood as reactive specimen. You must    |
|                 |     see a visible colored line for the specimen to  |
|                 |     be interpreted as reactive.                     |
+-----------------+-----------------------------------------------------+
| **17**          | **[Hema-Strip]{.underline}**                        |
|                 |                                                     |
|                 | INFORM the participants that the next few slides    |
|                 | address the test procedure for Hema-Strip.          |
+-----------------+-----------------------------------------------------+
| **18**          | **[Hema-Strip: Getting Ready]{.underline}**         |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
+-----------------+-----------------------------------------------------+
| **19**          | **[Hema-Strip: Collecting Specimen]{.underline}**   |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | ENSURE participants understand that either blood    |
|                 | from a finger prick or serum from a vial is used,   |
|                 | but [not both]{.underline}.                         |
+-----------------+-----------------------------------------------------+
| **20**          | **[Hema-Strip: Buffer Preparation]{.underline}**    |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | ADD the following information to Step 5:            |
|                 |                                                     |
|                 | -   The buffer vial should be placed in such a way  |
|                 |     that the foil side is facing up.                |
+-----------------+-----------------------------------------------------+
| **21**          | **[Hema-Strip: Applying Specimen and Buffer to Test |
|                 | Strip]{.underline}**                                |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
+-----------------+-----------------------------------------------------+
| **22**          | **[Hema-Strip: Getting Results]{.underline}**       |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | ADD the following information for Step 8:           |
|                 |                                                     |
|                 | -   If a timer is not available, use your watch or  |
|                 |     clock on the wall to monitor the time.          |
|                 |                                                     |
|                 | -   It is a good practice to write down the         |
|                 |     starting time or projected end time to help you |
|                 |     keep track of time.                             |
|                 |                                                     |
|                 | ADD the following information for Step 9:           |
|                 |                                                     |
|                 | -   In addition to test results, the tester should  |
|                 |     also record on appropriate forms the following  |
|                 |     information:                                    |
|                 |                                                     |
|                 |     -   The test date                               |
|                 |                                                     |
|                 |     -   Client identification                       |
|                 |                                                     |
|                 |     -   Name of the person performing the test      |
|                 |                                                     |
|                 |     -   The name of test                            |
|                 |                                                     |
|                 |     -   The expiration date                         |
|                 |                                                     |
|                 |     -   Test lot number                             |
|                 |                                                     |
|                 |     -   Control lot number                          |
+-----------------+-----------------------------------------------------+
| **23**          | **[Hema-Strip: Test Interpretation]{.underline}**   |
|                 |                                                     |
|                 | REMIND the participants how to read the Hema-Strip  |
|                 | results.                                            |
|                 |                                                     |
|                 | -   There are three possible test results:          |
|                 |     reactive, non-reactive, and invalid.            |
|                 |                                                     |
|                 | -   Any visible line in the patient/client window   |
|                 |     should be read as reactive, when the control    |
|                 |     line is also visible.                           |
+-----------------+-----------------------------------------------------+
| **24**          | **[OraQuick]{.underline}**                          |
|                 |                                                     |
|                 | INFORM the participants that the next few slides    |
|                 | address the test procedure for OraQuick.            |
+-----------------+-----------------------------------------------------+
| **25**          | **[OraQuick: Getting Ready]{.underline}**           |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | REMIND participants to have on hand the blue stand  |
|                 | that is included in the kit.                        |
|                 |                                                     |
|                 | -   To prevent contamination, leave the testing     |
|                 |     device in its pouch, until needed               |
|                 |                                                     |
|                 | -   Do not touch the flat pad                       |
|                 |                                                     |
|                 | -   Carefully place the vial in the stand. Do not   |
|                 |     snap the vial in the stand as splashing may     |
|                 |     occur.                                          |
+-----------------+-----------------------------------------------------+
| **26**          | **[OraQuick: Collecting Specimen (Blood or Oral     |
|                 | Fluids)]{.underline}**                              |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | REMIND participants to discard the loop in a        |
|                 | bio-hazard container.                               |
+-----------------+-----------------------------------------------------+
| **27**          | **[OraQuick: Transferring Specimen (Blood           |
|                 | Only)]{.underline}**                                |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | EMPHASIZE this step is for blood specimens only.    |
|                 | Oral fluids do not need this step.                  |
+-----------------+-----------------------------------------------------+
| **28**          | **[OraQuick: Inserting Test Device Into Buffer      |
|                 | Vial]{.underline}**                                 |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | -   Do not remove the device from the vial until    |
|                 |     you are done reading the results                |
+-----------------+-----------------------------------------------------+
| **29**          | **[OraQuick: Getting Results]{.underline}**         |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | ADD the following information for Step 8:           |
|                 |                                                     |
|                 | -   If a timer is not available, use your watch or  |
|                 |     clock on the wall to monitor the time.          |
|                 |                                                     |
|                 | -   It is a good practice to write down the         |
|                 |     starting time or projected end time to help you |
|                 |     keep track of time.                             |
|                 |                                                     |
|                 | ADD the following information for Step 9:           |
|                 |                                                     |
|                 | -   In addition to test results, the tester should  |
|                 |     also record on appropriate forms the following  |
|                 |     information:                                    |
|                 |                                                     |
|                 |     -   The test date                               |
|                 |                                                     |
|                 |     -   Client identification                       |
|                 |                                                     |
|                 |     -   Name of the person performing the test      |
|                 |                                                     |
|                 |     -   The name of test                            |
|                 |                                                     |
|                 |     -   The expiration date                         |
|                 |                                                     |
|                 |     -   Test lot number                             |
|                 |                                                     |
|                 |     -   Control lot number                          |
+-----------------+-----------------------------------------------------+
| **30**          | **[OraQuick: Test Interpretation]{.underline}**     |
|                 |                                                     |
|                 | REMIND the participants how to read the OraQuick    |
|                 | results.                                            |
|                 |                                                     |
|                 | -   There are three possible test results:          |
|                 |     reactive, non-reactive, and invalid.            |
|                 |                                                     |
|                 | -   Any visible line within the triangle of the     |
|                 |     Test(client) area should be read as reactive,   |
|                 |     when the control line is also visible within    |
|                 |     the C triangle.                                 |
+-----------------+-----------------------------------------------------+
| **31**          | **[Uni-Gold]{.underline}**                          |
|                 |                                                     |
|                 | INFORM the participants that the next few slides    |
|                 | address the test procedure for Uni-Gold.            |
+-----------------+-----------------------------------------------------+
| **32**          | **[Uni-Gold: Getting Ready]{.underline}**           |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | ADD the following information to Step 1:            |
|                 |                                                     |
|                 | -   The plastic pipette is included in the kit.     |
+-----------------+-----------------------------------------------------+
| **33**          | **[Uni-Gold: Collecting Specimen]{.underline}**     |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | ENSURE participants understand that either blood    |
|                 | from a finger prick or serum from a vial is used,   |
|                 | but [not both]{.underline}.                         |
+-----------------+-----------------------------------------------------+
| **34**          | **[Uni-Gold: Adding Specimen and Reagent to Test    |
|                 | Device]{.underline}**                               |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | -   Check to ensure the sample immediately moves    |
|                 |     along the test device.                          |
|                 |                                                     |
|                 | -   If not, add one more drop of buffer.            |
+-----------------+-----------------------------------------------------+
| **35**          | **[Uni-Gold: Getting Results]{.underline}**         |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | ADD the following information for Step 6:           |
|                 |                                                     |
|                 | -   If a timer is not available, use your watch or  |
|                 |     clock on the wall to monitor the time.          |
|                 |                                                     |
|                 | -   It is a good practice to write down the         |
|                 |     starting time or projected end time to help you |
|                 |     keep track of time.                             |
|                 |                                                     |
|                 | ADD the following information for Step 7:           |
|                 |                                                     |
|                 | -   In addition to test results, the tester should  |
|                 |     also record on appropriate forms the following  |
|                 |     information:                                    |
|                 |                                                     |
|                 |     -   The test date                               |
|                 |                                                     |
|                 |     -   Client identification                       |
|                 |                                                     |
|                 |     -   Name of the person performing the test      |
|                 |                                                     |
|                 |     -   The name of test                            |
|                 |                                                     |
|                 |     -   The expiration date                         |
|                 |                                                     |
|                 |     -   Test lot number                             |
|                 |                                                     |
|                 |     -   Control lot number                          |
+-----------------+-----------------------------------------------------+
| **36**          | **[Uni-Gold: Test Interpretation]{.underline}**     |
|                 |                                                     |
|                 | REMIND the participants how to read the Uni-Gold    |
|                 | results.                                            |
|                 |                                                     |
|                 | -   There are three possible test results:          |
|                 |     reactive, non-reactive, and invalid.            |
|                 |                                                     |
|                 | -   Any visible line in the patient/client window   |
|                 |     should be read as reactive, when the control    |
|                 |     line is also visible.                           |
+-----------------+-----------------------------------------------------+
| **Logistics     | Show the following 2 slides before moving           |
| Notes**         | participants out of the dry room.                   |
+-----------------+-----------------------------------------------------+
| **37**          | **[Activity: Workspace Setup]{.underline}**         |
|                 |                                                     |
|                 | INFORM all participants that they are going to      |
|                 | setup their own Workspaces in the practical room    |
|                 | where the lab session will be conducted.            |
|                 |                                                     |
|                 | READ the instructions on the slide.                 |
+-----------------+-----------------------------------------------------+
| **38**          | **[Hands-On Practice: Individual                    |
|                 | Tests]{.underline}**                                |
|                 |                                                     |
|                 | EXPLAIN the instructions for hands-on practice      |
|                 | session.                                            |
|                 |                                                     |
|                 | EMPHASIZE that participants should not discard      |
|                 | their test devices until the instructor has checked |
|                 | them.                                               |
+-----------------+-----------------------------------------------------+
| **Workspace     |                                                     |
| setup (Room     |                                                     |
| B)**            |                                                     |
+-----------------+-----------------------------------------------------+
| **Activity**    | ASK participants to move to Room B (the practical   |
|                 | room).                                              |
| **10 minutes**  |                                                     |
|                 | After Workspaces have been set up:                  |
|                 |                                                     |
|                 | -   DIVIDE the participants into two groups: Group  |
|                 |     I and Group II.                                 |
|                 |                                                     |
|                 | -   ASK Group I to stay in the practical room for   |
|                 |     demo and practice while Group II goes back to   |
|                 |     the dry room for video presentation.            |
+-----------------+-----------------------------------------------------+
| **Logistics     | Group I (demo and practice) and Group II (video)    |
| Notes**         | activities happen concurrently. After 1 hour 15     |
|                 | minutes, switch the groups so that Group I will     |
|                 | move to the dry room to watch the video while Group |
|                 | II will move to the practical room for demo and     |
|                 | practice.                                           |
+-----------------+-----------------------------------------------------+
| **Concurrent    |                                                     |
| Session: Demo   |                                                     |
| and Practice    |                                                     |
| (Room B)**      |                                                     |
+-----------------+-----------------------------------------------------+
| ![](m           | To facilitate retention, follow the sequence below  |
| edia/image3.gif | for the demo and practice session:                  |
| ){width="0.4479 |                                                     |
| 166666666667in" | -   Instructor demonstration (Test 1)               |
| height="0.54166 |                                                     |
| 66666666666in"} | -   Participant practice (Test1)                    |
| ***TIPS***      |                                                     |
|                 | -   Instructor demonstration (Test 2)               |
|                 |                                                     |
|                 | -   Participant practice (Test 2)                   |
|                 |                                                     |
|                 | -   Instructor demonstration (Test 3)               |
|                 |                                                     |
|                 | -   Participant practice (Test 3)                   |
|                 |                                                     |
|                 | To save time, after instructor's demonstration of   |
|                 | one test, participants can start their hands-on     |
|                 | practice during the incubation time of the          |
|                 | instructor's test. Therefore, each set of demo and  |
|                 | practice should take 20-25 minutes. The total time  |
|                 | for the demo-and-practice session will be no more   |
|                 | than 75 minutes.                                    |
+-----------------+-----------------------------------------------------+
| **              | DEMONSTRATE the procedure for \_\_\_\_\_\_\_        |
| Demonstration** | (test 1) using specimens labelled as positive and   |
|                 | negative.                                           |
| **15            |                                                     |
| minutes/test**  | ASK participants to gather around you while you     |
|                 | demonstrate.                                        |
+-----------------+-----------------------------------------------------+
| ![](m           | When demonstrating,                                 |
| edia/image3.gif |                                                     |
| ){width="0.4479 | -   Commit to memory each step in the testing       |
| 166666666667in" |     procedure and relevant notes                    |
| height="0.54166 |                                                     |
| 66666666666in"} | ```{=html}                                          |
| ***TIPS***      | <!-- -->                                            |
|                 | ```                                                 |
|                 | -   Have one-pager handy for easy reference         |
|                 |                                                     |
|                 | -   Show each step slowly and methodically          |
|                 |                                                     |
|                 | ```{=html}                                          |
|                 | <!-- -->                                            |
|                 | ```                                                 |
|                 | -   Talk out loud as you perform, but keep your     |
|                 |     explanation brief and clear                     |
|                 |                                                     |
|                 | -   If you repeat the procedure, make sure each     |
|                 |     time you do exactly the same thing so you don't |
|                 |     confuse the participants                        |
|                 |                                                     |
|                 | ```{=html}                                          |
|                 | <!-- -->                                            |
|                 | ```                                                 |
|                 | -   Point out commonly made mistakes during         |
|                 |     incubation time                                 |
|                 |                                                     |
|                 | -   Allow time for Q &A                             |
+-----------------+-----------------------------------------------------+
| **Practice**    | ASK participants to pull out of their manual the    |
|                 | one-page job aids for easy reference during the     |
| **15            | practice session. (Note: There will not be enough   |
| minutes/test**  | room on tabletop for supplies and binder.)          |
|                 |                                                     |
|                 | REMIND participants of the instructions for the     |
|                 | hands-on practice.                                  |
+-----------------+-----------------------------------------------------+
| ![](m           | INFORM participants that:                           |
| edia/image3.gif |                                                     |
| ){width="0.4479 | -   If timers are not available, the clock on the   |
| 166666666667in" |     wall is for their use during testing practice.  |
| height="0.54166 |                                                     |
| 66666666666in"} | -   They should feel free to raise their hands if   |
| ***TIPS***      |     they need anything or have a question.          |
|                 |                                                     |
|                 | -   They should record results using worksheet      |
|                 |     provided.                                       |
|                 |                                                     |
|                 | MONITOR participant performance during the          |
|                 | practice.                                           |
|                 |                                                     |
|                 | -   Provide as much personal attention and          |
|                 |     assistance as possible.                         |
|                 |                                                     |
|                 | -   Make sure participants are following the right  |
|                 |     procedures.                                     |
+-----------------+-----------------------------------------------------+
| **Logistics     | After one round of demonstration and practice (for  |
| Notes**         | one test), repeat the same process for test 2 and   |
|                 | test 3.                                             |
+-----------------+-----------------------------------------------------+
| **Concurrent    |                                                     |
| Session: Video  |                                                     |
| Presentation    |                                                     |
| and Discussion  |                                                     |
| (Room A)**      |                                                     |
+-----------------+-----------------------------------------------------+
| ![](me          | This video includes segments for 6 tests. Show the  |
| dia/image2.wmf) | video segments and slides for [relevant             |
| {width="0.49166 | tests]{.underline} only. Use the video counter      |
| 666666666664in" | below to help you cue up the right segment.         |
| heigh           |                                                     |
| t="0.4416666666 |   ----------------------------- ------------------  |
| 6666665in"}***C |   **Videotape Section**         **Counter           |
| ustomization*** |                                 Reading**           |
|                 |                                                     |
| ***Notes***     |   Capillus                      14:35               |
|                 |                                                     |
| **39-44**       |   Determine                     20:25               |
|                 |                                                     |
|                 |   Hema-Strip                    25:33               |
|                 |                                                     |
|                 |   OraQuick                      30:35               |
|                 |                                                     |
|                 |   Uni-Gold                      36:55               |
|                 |                                                     |
|                 |   Virocheck                     41:07               |
|                 |   ----------------------------- ------------------  |
+-----------------+-----------------------------------------------------+
| ![](m           | Show the video [one segment at a time]{.underline}. |
| edia/image3.gif | Never show the video segments all at once without   |
| ){width="0.4479 | discussing in between.                              |
| 166666666667in" |                                                     |
| height="0.54166 | Use the relevant slide both before                  |
| 66666666666in"} | [and]{.underline} after each segment. The slide     |
| ***TIPS***      | serves the following purposes:                      |
|                 |                                                     |
|                 | -   Before the video, it directs participants'      |
|                 |     attention to the key messages in the video.     |
|                 |                                                     |
|                 | -   After the video, you can use the questions on   |
|                 |     the slide to review key learning points.        |
+-----------------+-----------------------------------------------------+
| **40**          | **[Video: Capillus]{.underline}**                   |
|                 |                                                     |
| ![](m           | FOLLOW the procedure for showing the video segment. |
| edia/image4.wmf |                                                     |
| ){width="0.5534 | > INFORM participants that they are going to watch  |
| 722222222223in" | > a video about (Test Name).                        |
| height="0.32638 | >                                                   |
| 88888888889in"} | > POINT OUT the questions on the slide, which you   |
|                 | > expect them to answer at the end of the video     |
| ***Video***     | > segment.                                          |
|                 | >                                                   |
|                 | > ENCOURAGE participants to take notes while        |
|                 | > watching the video.                               |
|                 | >                                                   |
|                 | > PLAY the video.                                   |
|                 | >                                                   |
|                 | > ANSWER any questions participants have.           |
|                 | >                                                   |
|                 | > DEBRIEF by asking participants to answer the      |
|                 | > questions on the slide.                           |
+-----------------+-----------------------------------------------------+
| **41**          | **[Video: Determine]{.underline}**                  |
|                 |                                                     |
| ![](m           | FOLLOW the standard procedure (see above) for       |
| edia/image4.wmf | showing the video segment.                          |
| ){width="0.5534 |                                                     |
| 722222222223in" |                                                     |
| height="0.32638 |                                                     |
| 88888888889in"} |                                                     |
|                 |                                                     |
| ***Video***     |                                                     |
+-----------------+-----------------------------------------------------+
| **42**          | **[Video: Hema-Strip]{.underline}**                 |
|                 |                                                     |
| ![](m           | FOLLOW the standard procedure (see above) for       |
| edia/image4.wmf | showing the video segment.                          |
| ){width="0.5534 |                                                     |
| 722222222223in" |                                                     |
| height="0.32638 |                                                     |
| 88888888889in"} |                                                     |
|                 |                                                     |
| ***Video***     |                                                     |
+-----------------+-----------------------------------------------------+
| **43**          | **[Video: OraQuick]{.underline}**                   |
|                 |                                                     |
| ![](m           | FOLLOW the standard procedure (see above) for       |
| edia/image4.wmf | showing the video segment.                          |
| ){width="0.5534 |                                                     |
| 722222222223in" |                                                     |
| height="0.32638 |                                                     |
| 88888888889in"} |                                                     |
|                 |                                                     |
| ***Video***     |                                                     |
+-----------------+-----------------------------------------------------+
| **44**          | **[Video: Uni-Gold]{.underline}**                   |
|                 |                                                     |
| ![](m           | FOLLOW the standard procedure (see above) for       |
| edia/image4.wmf | showing the video segment.                          |
| ){width="0.5534 |                                                     |
| 722222222223in" |                                                     |
| height="0.32638 |                                                     |
| 88888888889in"} |                                                     |
|                 |                                                     |
| ***Video***     |                                                     |
+-----------------+-----------------------------------------------------+
| **End of        |                                                     |
| Concurrent      |                                                     |
| Session**       |                                                     |
+-----------------+-----------------------------------------------------+
| **Multiple HIV  |                                                     |
| tests video and |                                                     |
| slide           |                                                     |
| presentation    |                                                     |
| (Room A)**      |                                                     |
+-----------------+-----------------------------------------------------+
| ![](me          | Depending on the in-country testing algorithm and   |
| dia/image2.wmf) | tests used, the video segment "Multiple HIV Tests"  |
| {width="0.49166 | may not apply. However, it provides a good model    |
| 666666666664in" | for you to modify the content with in-country       |
| heigh           | examples. If you choose not to show this video      |
| t="0.4416666666 | segment, make sure you cover your discussion with   |
| 6666665in"}***C | all the key points from the video.                  |
| ustomization*** |                                                     |
|                 |                                                     |
| ***Notes***     |                                                     |
|                 |                                                     |
| **45**          |                                                     |
+-----------------+-----------------------------------------------------+
| ![](m           | **[Video: Multiple HIV Tests]{.underline}**         |
| edia/image4.wmf |                                                     |
| ){width="0.5534 | FOLLOW the standard procedure for showing video.    |
| 722222222223in" |                                                     |
| height="0.32638 | DISPLAY the slide before [and]{.underline} after    |
| 88888888889in"} | the video.                                          |
|                 |                                                     |
| ***Video***     |   ----------------------------- ------------------  |
|                 |   **Videotape Section**         **Counter           |
| **45**          |                                 Reading**           |
|                 |                                                     |
|                 |   Multiple HIV Tests            45:30               |
|                 |   ----------------------------- ------------------  |
|                 |                                                     |
|                 | REFRESH participants' memory of the in-country      |
|                 | testing algorithm.                                  |
|                 |                                                     |
|                 | FACILITATE a discussion of the procedures for       |
|                 | performing the specific in-country multi-test       |
|                 | algorithm. Discussion questions may include:        |
|                 |                                                     |
|                 | -   What preparation work is required?              |
|                 |                                                     |
|                 | -   How should you set up the testing area?         |
|                 |                                                     |
|                 | -   Which test should you do first? Why?            |
|                 |                                                     |
|                 | -   How should you set the timer for individual     |
|                 |     tests? For multiple tests?                      |
+-----------------+-----------------------------------------------------+
| ![](me          | Customize slides #46-48 by:                         |
| dia/image2.wmf) |                                                     |
| {width="0.49166 | -   Displaying your country's approved algorithm in |
| 666666666664in" |     slide #46.                                      |
| heigh           |                                                     |
| t="0.4416666666 | -   Deleting slide #48 if your country uses a       |
| 6666665in"}***C |     parallel algorithm.                             |
| ustomization*** |                                                     |
|                 | -   Deleting slide #47 if your country uses a       |
| ***Notes***     |     serial algorithm.                               |
|                 |                                                     |
| **46-48**       |                                                     |
+-----------------+-----------------------------------------------------+
| **46**          | **[Country Algorithm]{.underline}**                 |
|                 |                                                     |
|                 | REVIEW the country's algorithm.                     |
+-----------------+-----------------------------------------------------+
| **47**          | **[Possible Outcomes in a Parallel                  |
|                 | Algorithm]{.underline}**                            |
|                 |                                                     |
|                 | REFER participants to the Possible Outcomes handout |
|                 | in their manual.                                    |
|                 |                                                     |
|                 | ASK them to take it out of the manual for easy      |
|                 | reference during the next practice.                 |
|                 |                                                     |
|                 | REVIEW the slide with the participants.             |
+-----------------+-----------------------------------------------------+
| **48**          | **[Hands-On Practice: Multi-Test                    |
|                 | Algorithm]{.underline}**                            |
|                 |                                                     |
|                 | INFORM participants of the next activity.           |
|                 |                                                     |
|                 | EXPLAIN the hands-on practice:                      |
|                 |                                                     |
|                 | -   Participants will conduct tests simultaneously  |
|                 |     following the testing algorithm.                |
|                 |                                                     |
|                 | -   Participants will do this 5 times, each time    |
|                 |     using the designated blind specimen.            |
|                 |                                                     |
|                 | -   Participants will record individual test        |
|                 |     results and determine the HIV status of each    |
|                 |     specimen.                                       |
+-----------------+-----------------------------------------------------+
| **49**          | **[Hands-On Practice: Multi-Test Algorithm          |
|                 | (Cont'd)]{.underline}**                             |
|                 |                                                     |
|                 | READ the instructions on the slide.                 |
|                 |                                                     |
|                 | INFORM participants that they will now move to the  |
|                 | practical room for the demo and practice of         |
|                 | multi-test algorithm.                               |
+-----------------+-----------------------------------------------------+
| **Logistics     | After showing the ***Multiple HIV Tests*** video    |
| Notes**         | and slides 45-48, move the participants to the      |
|                 | practical room for the demo and hands-on practice   |
|                 | session.                                            |
+-----------------+-----------------------------------------------------+
| **Multiple HIV  |                                                     |
| test hands-on   |                                                     |
| practice        |                                                     |
| session (Room   |                                                     |
| B)**            |                                                     |
+-----------------+-----------------------------------------------------+
| **Practice**    | INFORM participants that:                           |
|                 |                                                     |
| **2 hours**     | -   If timers are not available, the clock on the   |
|                 |     wall is for their use during testing practice.  |
|                 |                                                     |
|                 | -   They should feel free to raise their hands if   |
|                 |     they need anything or have a question.          |
|                 |                                                     |
|                 | MONITOR participant performance during the          |
|                 | practice.                                           |
|                 |                                                     |
|                 | -   Provide as much personal attention and          |
|                 |     assistance as possible.                         |
|                 |                                                     |
|                 | -   Make sure participants are following the right  |
|                 |     procedures.                                     |
+-----------------+-----------------------------------------------------+
| **15 minutes**  | DEBRIEF the practice by:                            |
|                 |                                                     |
|                 | -   Discussing the results                          |
|                 |                                                     |
|                 | -   Pointing out the commonly-made mistakes you     |
|                 |     have observed during the practice session       |
|                 |                                                     |
|                 | -   Asking participants to share their experience   |
|                 |     and key learning from the practice              |
|                 |                                                     |
|                 | -   Answering any questions participants might have |
+-----------------+-----------------------------------------------------+
| **50**          | **[Summary]{.underline}**                           |
|                 |                                                     |
|                 | ASK participants to answer the questions on the     |
|                 | slide.                                              |
|                 |                                                     |
|                 | ANSWER any questions participants may have.         |
|                 |                                                     |
|                 | IDENTIFY participants who will be in the optional   |
|                 | hands-on session.                                   |
+-----------------+-----------------------------------------------------+