STD clinic worried after accuracy of rapid HIV test challenged
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* Patrick Sullivan

There is anxiety at Canada's busiest site for anonymous HIV testing because only 400 of 1900 people returned for retesting after taking a rapid HIV test that has produced false-negative results (see letter, page 119). Results for 1 returnee, who tested negative on the rapid test, came back positive after standard testing.

“We issued a press release asking for everyone to return for retesting and we keep running ads in gay papers and elsewhere,” says Jane Greer, director of the Hassle Free Clinic located in the heart of Toronto's gay village. “But the message hasn't been getting through.”

At issue are 2 “Fast-Check” HIV tests that were licensed by Health Canada in March 2000 (see Health and Drug Alert, page 170). Their accuracy was challenged by the British Columbia Centre for Disease Control in March 2002 (see letter, page 119). On Apr. 29, Health Canada announced that the manufacturer, BioChem ImmunoSystems, had agreed to halt all sales until further investigations were completed.

Greer says that's little consolation for her clinic, which is funded by the city of Toronto and saw 22 000 patients last year. It is one of the busiest testing sites for sexually transmitted disease in Canada.

She said the “point-of-care” rapid test had proved hugely popular since the Hassle Free Clinic started providing it in November 2001. The clinic was able to buy the tests, which usually sell for about $15, for $5.61. “It offered convenience and peace of mind, with results available in 15 minutes instead of a week and a half. Ninety percent of our clients chose it over the standard [enzyme immunoassay and Western blot] tests.”

The convenience was a major selling point for a clinic that attracts many transients because it offers free, anonymous testing and requires no health card. The clinic draws people from across both the province and the multicultural spectrum — a total of 47 different first languages have been recorded among its clients.

Although Greer does not criticize how Health Canada and the manufacturer initially responded to the BC findings, she said both “had dropped the ball” over publicizing concerns about false-negative results. “They left that up to us,” she said. — *Patrick Sullivan*, CMAJ