Rapid HIV Testing and Diagnostic Strategies in Resource-Limited Settings

Rapid HIV testing has transformed the diagnostic landscape in settings where laboratory infrastructure is scarce, enabling same-day results, timely linkage to care and streamlined treatment initiation. Point-of-care assays, most often lateral-flow immunoassays, detect HIV antibodies (and in some cases p24 antigen) with minimal equipment and training. Deployment strategies range from community-based screening campaigns to integration within primary healthcare clinics, antenatal services and blood transfusion centres. Optimal performance relies on validated testing algorithms, quality assurance systems and robust supply chains to ensure consistent reagent availability. Despite remarkable progress in accessibility, challenges persist: variable test sensitivity and specificity across regions, management of indeterminate or discordant results, and the risk of misdiagnosis due to suboptimal algorithms or procedural errors. Recent innovations include dual-antigen/antibody assays, simplified confirmatory tests deployable at the point of care and digital tools for real-time result reporting. Collectively, these advances aim to close diagnostic gaps, accelerate treatment targets and reduce HIV transmission in high-burden, low-resource environments.

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Rapid HIV Testing and Diagnostic Strategies in Resource-Limited Settings publication trend

The graph below shows the total number of articles in rapid hiv testing and diagnostic strategies in resource-limited settings across all publications each year (not limited to Nature Index journals).

Technical terms

Point-of-care testing (POCT): Diagnostic testing performed at or near the location of patient care, outside a central laboratory.

Rapid diagnostic test (RDT): A lateral-flow immunoassay designed to deliver qualitative detection of HIV antibodies or antigens within minutes.

Indeterminate result: A rapid test outcome characterised by weak or discordant lines that cannot be interpreted as definitively positive or negative.

Positive predictive value (PPV): The probability that an individual with a positive test result truly has HIV, influenced by test specificity and disease prevalence.

Enzyme immunoassay (EIA): A laboratory-based assay that uses enzyme-linked antigen or antibody conjugates to detect HIV markers with high sensitivity.

References

1. Longitudinal patterns in indeterminate HIV rapid antibody test results: a population-based, prospective cohort study. Microbiology Spectrum (2024).
2. Proficiency Testing of Viral Marker Screening in African Blood Centers — Seven African Countries, 2017. MMWR Morbidity and Mortality Weekly Report (2019).
3. To err is human, to correct is public health: a systematic review examining poor quality testing and misdiagnosis of HIV status. Journal of the International AIDS Society (2017).