Grant: Knowledge Synthesis Grant

Worldwide, about 33 million (30-36 million) are infected with HIV, 350 million people with Hepatitis B (HBV), and 130 million with Hepatitis C (HCV) infection. About 12 million new cases of Syphilis have been estimated per annum. All these sexually transmitted infections share common routes of transmission and facilitate disease progression and spread of HIV infection. Globally, a majority of individuals are unaware of their HIV/STI disease status due to inadequate care, and/or lack of access to timely screening and testing services. To increase disease detection of asymptomatic, marginalized at-risk populations and facilitate early treatment, agencies such as the UNAIDS, WHO and CDC, have called for scaling up of testing initiatives. Rapid diagnostic tests for HIV and STI's with their fast and accurate diagnoses aid in accomplishing these objectives. Oral rapid HIV tests are accurate but skepticism regarding their diagnostic accuracy prevails. Newer Antigen/Antibody based tests that detect acute infection are also available.To date, no meta-analyses has synthesized their diagnostic performance. Several newer studies on the rapid tests for Syphilis, Hepatitis B and C have been published yet no systematic review has synthesized their diagnostic accuracy. In this context, we propose three systematic reviews and meta-analyses to evaluate the overall performance (i.e., diagnostic accuracy and outcomes such as feasibility, acceptability, uptake, impact and cost effectiveness) of rapid tests for HIV, Syphilis, Hepatitis B and C. These reviews will not only generate evidence to help modify diagnostic algorithms for screening and diagnostic testing of vulnerable at risk populations but also inform and facilitate formation of new evidence based global and domestic guidelines to optimize testing initiatives for them.