An adult voluntary blood donor screens reactive on the first rapid HIV test at a NACO-supported testing centre. According to the national HIV testing strategy, how is diagnosis established?
- A Repeat the same rapid test twice more on the same sample
- B Perform two further rapid tests using kits based on different antigens or principles, and report positive only if all three are reactive ✓
- C Send the sample for Western blot confirmation before reporting any result
- D Report HIV-positive on the basis of a single reactive rapid test if the client has risk behaviour
Correct answer: B. Perform two further rapid tests using kits based on different antigens or principles, and report positive only if all three are reactive
Explanation
The NACO strategy uses serial testing: a reactive first-screening test is followed by a second and, if reactive, a third rapid test, each kit employing a different antigen set or assay principle to minimise false positivity independent of clinical history. Repeating the identical kit adds nothing because it shares the same antigen specificity. Western blot is costly and largely obsolete in Indian programme practice.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
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