HIV Rapid Tests

Dear doctors
I have been quite obssessive in the past but it´s over.
I just want an opinion of yours regarding rapid tests: some other professionals here on Medhelp state: "if you want to be sure about your HIV status you should get a lab-based test and not a rapid test" (http://www.medhelp.org/posts/HIV-Prevention/Accuracy-of-rapid-tests/show/1316320). Some other people here say this doctor meant "during window period", but that´s not what he meant. If I am wrong, excuse me. I am terrified of asking you this and also of mentioning other people's opinions because I might be misunderstood. But I swear I just want to clear things up.
Here in my country, these rapid tests are run for diagnostic purposes and not only at settings where you are not able to get a regular ELISA.
So, beyond a window period of three months, do rapid tests show exactly the same efficacy (sensitivity/specificity) as regular ELISAs (3rd or 4th generation)?
That´s a very serious question, regarding public health issues.
Thank you once again.

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

Hello,
Thank you very much for your post and welcome to our forum.
I can only answer relating to the rapid tests I am familiar with, used in the UK and following UK guidelines.  The test that we used is called INSTI, made in Canada by Byolitical Laboratories.  This test has a reliability of around 99.98% after 12 weeks window period, which is considered fully conclusive.  It is used routinely for diagnostic purposes every day and has same efficacy in sensitivity and specificity for HIV-1 and HIV-2 antibodies as any laboratory based ELISA test.
Best wishes,
Dr José

[Gluck75]

Am I supposed to choose one of the doctors here in order to my question answered? I think either one is fine.
Thank you.

[Gluck75]

This will be the last one. If you think it´s not fair, I can pay other 20 dollars. No problem at all, really.
What's your experience about OD values of 4th generation ELISAs in negative patients? Do you take Roche ones? I have negative results (Roche) of: 0.132 and 0.181 (cutoff of 1.00). I've seen other people showing lower results (0.01; 0.07). Do you routinely see higher negative values than those of mine? Crazy question, I know.
Personally, what's your thoguhts (personal or as a doctor) about this sad disease (AIDS)? Don't you think human beings should make this disease less mentally painful?
Thank you. I won't bother you anymore.

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

Please do not pay attention to those figures.  They do not mean anything and provided they are below 1.00, they are always negative.  Therefore do not even waste a second worrying about it.  We see all sort of levels and provided they are below 1.00, they are always negative, lower than yours, or higher than yours.
Personally I believe that there are far worse conditions than HIV and AIDS.  I think that the situation with HIV has changed dramatically in the last few years and that medication has mede a huge difference in the prognosis of this condition.  I think what is wrong is the stigma associated with it and the ignorance about it.  In any case, it is much more likely that you or me would develop conditions like cancer, diabetes or heart disease, with terrible complications and no prospect of cure, but somehow people do not seem to worry about it, and they get in such a state about HIV.
Best wishes,
Dr José