Seattle's Public Health Department has found evidence that the only rapid HIV test licensed to screen both saliva and blood (OraQuick) was not as accurate as the manufacturer claimed - it missed 8% of 133 people who were later found to have HIV. These results raise a question for all jurisdictions using oral testing: is reaching a wider range of people with testing worth it, if the results may be flawed?

Since the introduction of OraQuick in 2004, spikes in false positives have been reported at least twice, causing alarm in San Francisco in 2005 and halting use of the test in New York City. But in some ways the Seattle results are more troubling. False positives can be re-tested with rapid blood tests immediately, but false negatives represent missed opportunities to diagnose people who

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