False-Positive Oral Fluid Rapid HIV Tests – New York City, 2005-2008

This report discusses the problem of the increase in the number of false-positive oral fluid reactive rapid tests in New York City. In January 2004, the city introduced on-site rapid HIV testing in STD clinics. This was replaced by oral fluid testing with the OraQuick Advance Rapid HIV-1/2 Antibody Test. In late 2005, an increase in the number of false-positive oral fluid tests occurred, but the increase subsided after several months. During investigation of the false-positive oral fluid test results, the city returned to finger-stick whole-blood rapid testing, which produced no false-positive test results. The city resumed oral fluid rapid testing, with immediate follow-up finger stick whole blood testing, using a second OraQuick test, after any reactive oral fluid test result. In 2007, there was a larger increase in the incidence of false-positive oral fluid rapid test results. The city again suspended oral fluid testing in STD clinics and used finger-stick whole-blood testing as the only rapid HIV test in STD clinics. The cause for the episodic increases in false-positive oral fluid tests has not been determined.