# Presentation: 023033

## Module 9:Performing HIV Rapid Tests

**Demonstration and Practice**

## Learning Objectives

- At the end of this module, you will be able to:
- Perform 3 HIV rapid tests according to SOP
- Insert Test 1 name
- Insert Test 2 name
- Insert Test 3 name
- Perform multiple tests simultaneously
- Accurately interpret individual test results
- Accurately determine HIV status

## Content Overview

**Optional hands-on session**

## Capillus

## Capillus: Getting Ready

**1.  Collect test items and other **
**	****necessary lab supplies**

**2.  Label the device with client **
**	****identification number**

**3.  Place slide on the black **
**	****interpretation card . Ensure **
**	****that slide is right side up.**

## Capillus: Reagent Preparation

**4. Gently mix the latex reagent well **
**	****ensuring that it is homogenous**

**5.  Use the dropper to draw the latex **
**	****reagent up to the calibration mark. **
**	****Avoid drawing up air bubbles.**

**6.  Dispense the reagent into the mixing **
**	****well, away from the capillary channel. **
**	****Do not allow the dropper to touch **
**	****the slide.**

## Capillus: Collecting Specimen

**7.  Collect 10 μl of specimen using  a ****	****new disposable pipette tip with the pre-calibrated pipette.**

## Capillus: Applying Specimen to Test Slide

**9. Mix the specimen and latex by gently pumping the mixture in and out of the tip 3 times.  Stir in a circular motion at least 5 times.**

**10. Initiate the capillary flow by moving the mixture to the opening of the channel using the pipette.**

**8. Hold the pipette directly over the well and dispense the specimen directly into the latex solution**

## Capillus: Getting Results

**11.   Allow the latex mixture to flow **
**	****through the entire channel and into ****	****the viewing window (about 3-7 min.) before reading the results.**

**12.   Read and record the results ****	****and other pertinent info on ****	****the worksheet.**

## Capillus – Test Interpretation 

**Reactive**

**Non-reactive**

## Determine

## Determine: Getting Ready

**2.  Use 1 strip per test and be sure **
**	****to preserve the lot number on the remaining packet of strips**

**1.  Collect test items and other **
**	****necessary lab supplies**

**3.  Label the test strip with client **
**	****identification number**

**4. Pull off the protective foil cover**

## Determine: Collecting Specimen 

**5. Collect 50 μl of specimen using a precision pipette or 1 drop using a plastic transfer pipette**

## Determine: Applying Specimen and Buffer to Test Strip

**7.   **_**For whole blood only**_** add 1 drop **
**	****of chase buffer to the specimen pad**

**6.  Apply the specimen to the **
**	****absorbent pad on the strip**

## Determine: Getting Results

**8.  Wait 15 minutes (no longer than **
**	****60 minutes) before reading the **
**	****results**

**9.  Read and record the results **
**	****and other pertinent info on the **
**	****worksheet**

## Determine - Test Interpretation

**Reactive**

**Invalid**

**Non-reactive**

## Hema-Strip

## Hema-Strip: Getting Ready

**1.  Collect test items and other **
**	****necessary lab supplies**

**2.  Label device with the client **
**	****identification number **

## Hema-Strip: Collecting Specimen 

**3. Collect specimen directly from the finger-stick. Touch specimen with device tip until tip is full.**

## Hema-Strip: Buffer Preparation

**4.  Remove buffer vial – **
**	****separate from top of  device**

**5.  Place buffer vial on a flat surface**

## Hema-Strip: Applying Specimen and Buffer to Test Strip

**6.  Firmly press the device tip through **
**	****the foil cover.  Continue pushing **
**	****device, usually 2 more times, to the **
**	****bottom of vial until device and **
**	****buffer vial snap together tightly. **

**7.  Place the test device upright **
**	****in a rack **

## Hema-Strip: Getting Results

**9.  Read and record the results **
**	****and other pertinent info on the worksheet **

**8.  Wait 15 minutes before reading **
**	****the results **

## Hema-Strip: Test Interpretation

**Reactive**

**Invalid**

**Non-reactive**

## OraQuick

## OraQuick: Getting Ready

**1. Collect test items and other **
**	****necessary lab supplies**

**2.  Set reusable stand on a flat, **
**	****level surface. Partially remove device from package and label device and the developer vial with client identification number. **

**3.  Carefully uncap the developer vial **
**	****and place vial into the stand **

## OraQuick: Collecting Specimen (Blood or Oral Fluids)

**4.  Collect approximately 5 μl of specimen using a new disposable loop**

**4.   Instruct the client to use the pad end of the test device to swab completely across the outside of the upper and lower gums, one time around**

## OraQuick: Transferring Specimen (Blood Only) 

**5.  Transfer the collected specimen **
**	****to the vial**

**6.  Stir the specimen in the vial **
**	****with t he loop**

## OraQuick: Inserting Test Device Into Buffer Vial 

**7.  Insert the device pad completely into the vial **
**	****with the result window facing forward**

## OraQuick: Getting Results

**8.  Wait 20 minutes (no longer than **
**	****40 min.) before reading the results**

**9.   Read and record the results and **
**	****other pertinent info on the worksheet**

## OraQuick: Test Interpretation

**Reactive**

**Invalid**

**Non-reactive**

## Uni-Gold

## Uni-Gold: Getting Ready

**1.  Collect test items and other **
**	****necessary lab supplies**

**2.  Remove device from package **
**	****and label device with client **
**	****identification number **

## Uni-Gold: Collecting Specimen 

**3. Collect specimen using the disposable pipette**

## Uni-Gold: Adding Specimen and Reagent to Test Device

**4.   Add 2 drops (approx. 60μl) of **
**	****specimen to the sample port in the device**

**5.  Add 2 drops (approx. 60μl) of the **
**	****appropriate wash reagent to sample **
**	****port**

## Uni-Gold: Getting Results

**6.  Wait for 10 minutes (no longer than **
**	****20 min.) before reading the results**

**7.  ****	****Read and record the results and **
**	****other pertinent info on the worksheet**

## Uni-Gold: Test Interpretation

**Reactive**

**Invalid**

**Non-reactive**

## Activity: Workspace Setup

- Instructions:
- Identify your Workspace in the practical room
- Gather test kits and supplies
- Obtain reactive and non-reactive specimens from instructor
- Arrange all items at your work station
- Activity time: 10 minutes

## Hands-On Practice: Individual Tests

- Instructions:
- Use safety precautions
- Practice with blood _provided by your instructor only_
- Raise your hand if you need additional supplies
- Show your test results to instructor after you are done
- Total time: 15 minutes per test

## Video Presentation and Discussion

## Video: Capillus

- Key learning points
- What preparation is required for the test kit before testing?
- What are the components in the test kit?
- What are controls for?  How do you use them?
- What information needs to be recorded, and where?
- How should you position the slide? Why do you place the slide on a black interpretation card?
- How do you collect blood?  What device do you use?
- How long do you set the timer?
- How many results are possible?  How do you read them?

## Video: Determine

- Key learning points
- What preparation is required for the test kit before testing?
- What are the components in the test kit?
- What do you need to preserve when tearing test strip form the packet?
- What information needs to be recorded, and where?
- How do you collect blood?  What device do you use?
- Which step can you omit when using serum or plasma?
- How long do you set the timer?
- How many results are possible? How do you read them?

## Video: Hema-Strip

- Key learning points
- What preparation is required for the test kit before testing?
- What are the components in the test kit?
- When you open the test packet, what do you need to check?
- What information needs to be recorded, and where?
- How do you collect blood?  What device do you use?
- How long do you set the timer?
- How many results are possible? How do you read them?

## Video: OraQuick

- Key learning points
- What preparation is required for the test kit before testing?
- What are the components in the test kit?
- What information needs to be recorded, and where?
- How do you collect blood?  What device do you use?
- How do you collect oral fluids? What device do you use?
- How long do you set the timer?
- How many results are possible? How do you read them?

## Video: Uni-Gold

- Key learning points
- What preparation is required for the test kit before testing?
- What are the components in the test kit?
- What information needs to be recorded, and where?
- How do you collect blood?  What device do you use?
- How long do you set the timer?
- How many results are possible? How do you read them?

## Video: Multiple HIV Tests

- Key learning points
- What are the advantages of performing more than one test at a time?
- Why must you keep two test kits separate when performing both at the same time?
- Do you collect blood at the same time or separately when performing multiple tests?
- How do you set the timer when two tests require different wait time?
- When is a tie-breaker used?  How does it determine HIV status?

## Country Algorithm

*Display approved country algorithm here*

## Possible Outcomes in a Parallel Algorithm

| TEST 1 | TEST 2 | TEST 3 | HIV Status |
| --- | --- | --- | --- |
| Non-reactive | Non-reactive |  | Negative |
| Reactive | Reactive |  | Positive |
| Non-reactive | Reactive | Non-reactive | Negative |
| Reactive | Non-reactive | Non-reactive | Negative |
| Non-reactive | Reactive | Reactive | Positive |
| Reactive | Non-reactive | Reactive | Positive |

**Notes:**
Invalid test needs to be repeated 
Does not count toward outcome of test

## Hands-On Practice:Multi-Test Algorithm

- Conduct test 1 and test 2 simultaneously following the multi-test algorithm.  Perform the algorithm using the 5 designated blind specimens and determine HIV status of each.

## Instructions:
Collect supplies and obtain panel of blind specimens
Organize your workspace
Complete one algorithm before starting the next
Don’t forget – Use safety precautions
Practice on blood provided by your instructor only 
Raise your hands if you need additional supplies
Record results on worksheet
Keep test devices - instructor will check results before discarding of devices

Total time: 2 hours

- Collect supplies and obtain panel of blind specimens
- Organize your workspace
- Complete one algorithm before starting the next
- Don’t forget – Use safety precautions
- Practice on blood _provided by your instructor only_
- Raise your hands if you need additional supplies
- Record results on worksheet
- Keep test devices - instructor will check results before discarding of devices
- Total time: 2 hours

**Hands-On Practice: Multi-Test Algorithm ****(Cont’d)**

## Summary

- Describe the key learning from performing:
- (In-country test 1)
- (In-country test 2)
- (In-country test 3)
- Describe the key learning from performing the multi-test algorithm