Within the past decade, HIV prevalence in Cameroon has dropped significantly from 11.8% in 2002 to 4.3% in 2015, but the quality of HIV rapid test results is still a challenge. Data from a 2012 HIV sentinel survey among pregnant women tested showed 18.8% received false negative results. Therefore, achieving HIV epidemic control by 2020 in accordance with the UNAIDS 90-90-90 targets critically depends on the accuracy of “the first 90”. The HIV Rapid Test Quality Improvement Initiative (RT-QII) is a catalytic effort, building upon in-country PEPFAR programs to address known gaps in the quality assurance cycle (QAC) of HIV rapid testing.Between June 2014 and April 2016, 169 HIV RT sites were selected from four regions in Cameroon to pilot RTQII. Twenty-eight quality corps volunteers (Q-Corps) were trained and competent on HIV rapid testing and QAC. Additionally, at least one staff from all selected sites was trained using a standardized comprehensive HIV quality assurance package. Sites were audited quarterly by Q-Corps using the SPI-RT checklist having 08 sections or major quality elements, and corrective actions were provided during monthly field visits. Baseline and last assessment data were compared using the chi-square test for site levels and a paired t-test for mean scores of different checklist elements.All 169 sites recorded significant (P<0.0001) progress with 34% at level 0, 33% at level I, 33% at level II, compared to 0% at level 0, 7% at level I, 66% at level II, 28% at level III during baseline and last assessments respectively. The mean scores (73%) of quality elements were significantly (P<0.006) higher at last assessment when compared to baseline (48%).RT-QII led to significant quality improvement in the pilot sites and will serve as an efficient approach for optimizing the quality management systems of all facilities providing HIV testing services in Cameroon.
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