Nadine Beckmann: Misdiagnosis in point-of-care rapid HIV testing – findings from a qualitative study in Zimbabwe

Dec 6 , 2022 

Pre­sen­ta­tion as part of the LSHTM Med­ical Anthro­pol­o­gy Seminar

A grow­ing num­ber of stud­ies high­light high lev­els of mis­di­ag­no­sis in the scale-up of HIV rapid test­ing pro­grammes, which often remain invis­i­ble to indi­vid­ual testers. In this talk, I explore how HIV testers in Zim­bab­we try to trans­late the dis­em­bod­ied norms of lab­o­ra­to­ry test­ing into the body work of imple­ment­ing HIV test­ing at the point of care in the face of resource-lim­it­ed and high-pres­sured work envi­ron­ments that chal­lenge testers’ con­fi­dence in the authen­tic­i­ty of their test results. I show how assump­tions built into the tech­nol­o­gy of HIV rapid tests can lead to a mis­match between intend­ed and actu­al uses of the tests, and poten­tial­ly, to mis­di­ag­no­sis. The study results cau­tion against a focus on user errors to explain mis­di­ag­no­sis and argue for build­ing a work envi­ron­ment that facil­i­tates trust, coop­er­a­tion and a calm, care­ful dis­po­si­tion – quite the oppo­site of a ‘rapid’ test – in order to achieve high qual­i­ty testing.

Dr Nadine Beck­mann, Assis­tant Pro­fes­sor in Med­ical Anthro­pol­o­gy, Depart­ment of Glob­al Health & Devel­op­ment, LSHTM