Abstract
Testing for HIV using rapid test devices assists in determining HIV status and
ascertains if treatment is required. Rapid HIV quality assurance (QA) training is conducted to
ensure accuracy of test results in non-laboratory settings.
Objectives: This study aimed to determine the factors associated with the accuracy of rapid
HIV testing among primary healthcare (PHC) workers who received HIV testing QA training
in the Eastern Cape, South Africa.
Method: A cross-sectional analytical study design was used to purposively recruit 167 PHC
workers with prior training on HIV testing QA. Data were collected in 2022 using a selfadministered
questionnaire. STATA version 17.0 was used for data analysis.
Results: Tester accuracy measured by a proficiency testing (PT) score of greater than 80% was
achieved among 64.7% of the testers. Comprehensive HIV QA training was significantly
associated with a PT score of greater than 80% (P = 0.001). On multivariable analyses, a PT
score of greater than 80% was less likely with rural facilities (adjusted odd ratios [aOR] = 0.56,
95% confidence interval [CI]: 0.36–0.92, P = 0.020), Grade 12 education (aOR = 0.40, 95% CI:
0.19–0.85, P = 0.017), mentorship (aOR = 0.55, 95% CI: 0.35–0.85, P = 0.008), and attitudes
towards inaccurate HIV results (aOR = 0.13, 95% CI: 0.02–0.82, P = 0.03); while implementation
of QA processes (aOR = 3.94, 95% CI: 1.22–12.74, P = 0.022) and elements of QA in the HIV
Testing Services register (aOR = 4.93, 95% CI: 1.45–16.74, P = 0.011) were associated with a PT
score of greater than 80%.
Conclusion: Exposure to comprehensive rapid HIV QA training were associated with higher
tester accuracy. A framework for QA training is required for standardisation of training in the
country.