ArticlePoint of care2015
Barriers to Implementation of Rapid and Point-of-Care Tests for Human Immunodeficiency Virus Infection: Findings From a Systematic Review (1996-2014).
Article in Point of care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Barriers and facilitators to HIV and syphilis rapid diagnostic testing in antenatal care settings in low-income and middle-income countries: a systematic review.BMJ global health · 2022Pooled it
- Acceptability of point-of-care viral load testing to facilitate differentiated care: a qualitative assessment of people living with HIV and nurses in South Africa.BMC health services research · 2020Trial
- Brief Report: Cofactors of Mortality Among Hospitalized HIV-Infected Children Initiating Antiretroviral Therapy in Kenya.Journal of acquired immune deficiency syndromes (1999) · 2019Trial
- Scaling up point-of-care hepatitis C testing in Canada: protocol for a multilevel implementation science study of clinical processes, barriers, facilitators and implementation strategies (SCALE-POCT study).Implementation science communications · 2025Article
- Bridging the diagnostic gap: diagnostic capacity and pediatric quality of care in LMICs.BMC medicine · 2025Article
- Roadblocks of Urinary EV Biomarkers: Moving Toward the Clinic.Journal of extracellular vesicles · 2025Review
- Use of Measles and Rubella Rapid Diagnostic Tests to Improve Case Detection and Targeting of Vaccinations.Vaccines · 2024Review
- Optimising HIV drug resistance testing laboratory networks in Kenya: insights from systems engineering modelling.BMJ open · 2024Article
- Using queueing models as a decision support tool in allocating point-of-care HIV viral load testing machines in Kisumu County, Kenya.Health policy and planning · 2024Article
- Protocol for the development of an intervention to improve the use of Point-of-caRE DiagnostICs in the management of respiraTOry tRact infectionS in primary care (the PREDICTORS study).HRB open research · 2024Article
- Highly valued despite burdens: Qualitative implementation research on rapid tests for hospital-based SARS-CoV-2 screening.SSM. Qualitative research in health · 2022Article
- Bridging the gap between development of point-of-care nucleic acid testing and patient care for sexually transmitted infections.Lab on a chip · 2022Review
- The Lancet Commission on diagnostics: transforming access to diagnostics.Lancet (London, England) · 2021Review
- Exploring Primary Care Clinicians' Views about How Best to Implement a Potential Trial around Point-of-Care Tests for Common Infections in South Africa.Diagnostics (Basel, Switzerland) · 2021Article
- Article
- Cost-effectiveness of adoption strategies for point of care HIV viral load monitoring in South Africa.EClinicalMedicine · 2020Article
- Article
- Rapid diagnostic tests to address challenges for global measles surveillance.Current opinion in virology · 2020Review
- Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives.Diagnostics (Basel, Switzerland) · 2020Article
- Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Implementation of human immunodeficiency virus rapid and point-of-care tests (RDT/POCT) is understood to be impeded by many different factors that operate at 4 main levels-test devices, patients, providers, and health systems-yet a knowledge gap exists of how they act and interact to impede implementation. To fill this gap, and with a view to improving the quality of implementation, we conducted a systematic review.
methodsFive databases were searched, 16,672 citations were retrieved, and data were abstracted on 132 studies by 2 reviewers.
findingsAcross 3 levels (ie, patients, providers, and health systems), a majority (59%, 112/190) of the 190 barriers were related to the integration of RDT/POCT, followed by test-device-related concern (ie, accuracy) at 41% (78/190). At the patient level, a lack of awareness about tests (15/54, 28%) and time taken to test (12/54, 22%) dominated. At the provider and health system levels, integration of RDT/POCT in clinical workflows (7/24, 29%) and within hospitals (21/34, 62%) prevailed. Accuracy (57/78, 73%) was dominant only at the device level.
interpretationIntegration barriers dominated the findings followed by test accuracy. Although accuracy has improved during the years, an ideal implementation could be achieved by improving the integration of RDT/POCT within clinics, hospitals, and health systems, with clear protocols, training on quality assurance and control, clear communication, and linkage plans to improve health outcomes of patients. This finding is pertinent for a future envisioned implementation and global scale-up of RDT/POCT-based initiatives.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.