Background:
Rapid HIV testing is acceptable (and even preferable) to patients, and increases receipt of results. The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) operates 10 free Sexually Transmitted Disease (STD) clinics which offer a choice of rapid (OraQuick, with positives confirmed by Western Blot) or conventional HIV-1/2 testing (EIA, Western Blot).

Objective:
To compare characteristics of confidential patients choosing rapid versus conventional HIV testing.

Method:
Our observation period (October 2004-September 2005) coincided with a clinic-by-clinic electronic medical record (EMR) implementation. We compared, among rapid and conventional testers: demographics, HIV risk (sexual behaviors, intravenous drug use, partner with HIV risk, previous STD diagnosis), any STD diagnosis for testers receiving a concurrent exam, HIV seropositivity (confirmed) and receipt of HIV results.

Result:
There were 23,586 HIV tests recorded during the observation period; 92% (21,687/23,586) were rapid. Rapid and conventional testers had similar HIV seropositivity (rapid, 1.2% [262/21,687]; conventional, 1.7% [32/1,899], p=0.07), demographics (age, race/ethnicity, gender) and concurrent STD diagnosis. Most HIV risk behaviors were comparable, although rapid testers were more likely to report previous STD (rapid 18.3% [3,968/21,687]; conventional, 16.2% [307/1,899], p=0.019), 34.4% more likely to receive their results overall (rapid 97.8% [21,200/21,687]; conventional 63.3% [1,202/1,899], p<0.0001), and 20.7% more likely to receive their results among confirmed seropositives (rapid 98.9% [259/262]; conventional 78.1% [25/32], p<0.0001). 43.9% (115/262) of rapid positives received their confirmatory results.

Conclusion:
Rapid and conventional testers have similar HIV risk profiles at specimen collection. The higher proportion of rapid HIV positives receiving results makes rapid testing a valuable means of increasing HIV awareness, enabling behavior change, and reducing transmission.

Implications:
Rapid HIV testing should be incorporated into HIV services without concern for excluding high-risk groups. Given the demonstrated acceptability of rapid testing, and the higher receipt of results, testing programs might reserve conventional testing for times of operational necessity.