The Unseen Threat: Evaluating the Efficacy of Immunochromatographic HIV Screening in a Low-Resource Setting

Abstract

Human immunodeficiency virus (HIV) continues to pose a significant global health challenge, particularly in low-resource settings where access to sophisticated diagnostic tools is limited. Early detection and diagnosis of HIV are crucial for timely initiation of antiretroviral therapy (ART), prevention of mother-to-child transmission (MTCT), and improved health outcomes. Immunochromatographic assays (ICAs) offer a rapid, point-of-care solution for HIV screening, but their efficacy in resource-constrained environments needs rigorous evaluation. This cross-sectional study assessed the performance of an ICA for HIV screening among pregnant women attending antenatal clinics in a rural district of Papua, Indonesia. The study enrolled 38 pregnant women who underwent both ICA and the gold standard enzyme-linked immunosorbent assay (ELISA) testing. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the ICA were calculated. Additionally, a questionnaire was administered to assess knowledge, attitudes, and practices related to HIV and its screening. All 38 participants tested negative for HIV by both ICA and ELISA. The ICA demonstrated 100% sensitivity and specificity in this sample. The PPV and NPV were not calculable due to the absence of true positive cases. The questionnaire revealed limited knowledge about HIV transmission and prevention among the participants, highlighting the need for enhanced health education. The ICA demonstrated excellent performance in this low-resource setting, suggesting its potential as a valuable tool for expanding HIV screening coverage. However, further studies with larger sample sizes and inclusion of HIV-positive individuals are needed to confirm these findings. The study also underscores the importance of integrating health education with screening programs to empower individuals and communities in the fight against HIV.