PROVIDENCE, R.I. [Brown University] — Researchers at The Warren Alpert Medical School of Brown University have created the first educational video for patients to explain rapid tests for HIV, a relatively new tool in the fight against the AIDS epidemic.
The video gives an overview of rapid HIV tests, which can be administered simply with a saliva swab, a finger stick or a blood draw. Results are available in minutes. Brown researchers created the video to give health care providers and outreach workers an effective, efficient way to educate their patients about HIV and rapid HIV testing.
Conventional HIV tests require days of waiting for laboratory results, which is a barrier to testing. The federal Centers for Disease Control and Prevention (CDC) reports that many patients don’t even return for their results: 30 percent who tested HIV-positive and 39 percent who tested HIV-negative in 2000.
In September 2006, the CDC recommended routine, universal HIV screening in all health care settings. The new guidelines reaffirmed the use of pre-test information to educate patients about HIV and HIV testing. Brown researchers wanted to see whether a video would help streamline the testing process and, ultimately, boost the numbers of patients getting tested for the virus.
“With HIV, testing is key: If you don’t know you have the virus, you won’t protect others or get treatment for yourself,” said Roland Merchant, M.D., an assistant professor of emergency medicine and community health at Alpert Medical School and an attending physician at Rhode Island Hospital. “The power of rapid HIV testing is that results can be determined in a single healthcare visit. With rapid tests, prevention and treatment don’t have to wait.”
Merchant wrote and produced the video, titled Do You Know About Rapid HIV Testing?, with colleagues at Brown and the Harvard School for Public Health. Abbott Diagnostics Inc., which distributes OraQuick – a rapid HIV test approved by the federal Food and Drug Administration – paid for a portion of the production costs.
Merchant and his team created the 10-minute video for maximum impact. It is animated and jargon-free so that as many adults as possible can understand the explanation of HIV, how it is spread, and how the OraQuick test works. The free video is available on the Brown University AIDS Program Web site so that any HIV test provider can download it to share with patients, who can watch it on a waiting room television or on a laptop or handheld computer. The video can be shown to individuals or groups in any testing setting, from an outreach clinic to an emergency department.
Merchant and his team also tested the video’s effectiveness in two randomized, controlled pilot trials. In an article published in BioMed Central, the peer-reviewed, open-access publishing house, Brown and Harvard researchers compare how well emergency department patients comprehended rapid HIV pre-test information using different information delivery methods.
In the first trial of 73 patients, some received no testing information while others received HIV pre-test information from an HIV counselor. In the second trial, also conducted in the Rhode Island Hospital emergency department, 120 patients either watched the video or got pre-test information from a counselor. All patients were then given a questionnaire to test their understanding of the pre-test information.
Researchers found that patients who watched the video demonstrated as good or better comprehension of rapid HIV testing fundamentals than patients assigned to the counseling group.
Merchant said a larger trial is underway. But based on these preliminary results, Merchant said the video could be an effective substitute for in-person HIV discussions. California’s Office of AIDS is planning to use a modified version of the video in its testing programs.
“The video could be particularly helpful in busy, resource-strapped testing settings, where there are a limited number of counselors,” Merchant said.
The CDC and the National Institute for Allergy and Infectious Diseases sponsored the research.
Members of the Brown research team include Erin Gee, a former undergraduate student, Melissa Clark, an associate professor of community health, and Kenneth Mayer, M.D., a professor of medicine and community health. At the Harvard School of Public Health, George Seage III, an associate professor of epidemiology, and Victor DeGruttola, a professor of biostatistics, also took part in the work.