Background: The implementation of HIV point-of-care testing and upgrading of the service in arncountries with highly HIV prevalent is mandatory. However, the studies related to accuracies arernremaining limited. As a need to get HIV testing increases, the testing strategies and technology shift tornrapid test (RT) and point of care test (POC) which were used to decentralize the testing and includes nonrnlaboratory professionals as the complexity of the testing method was resolved. rnObjective: the aim of this study was to assess performance and associated factors of non medicalrnlaboratory professional working on rapid HIV testing in public health facilities of Adama, Oromia,rnEthiopia. rnMethods: Facility based cross-sectional study was conducted from February to April, 2020. A total ofrn348 non medical laboratory professionals were considered determining their performance and associatedrnfactors working on rapid HIV testing in health centers and hospital of Adama. Epidata version 3.1rnwas used for data entry and exported to SPSS version 23 for analysis and P-Value less than 0.05 wasrntaken as statistically significant.rnResults: Among 348 HIV rapid testing providers, 336 (96.6 %) could correctly detect negative andrnpositive panel samples and the rest 12 (3.4%) had discordant result during performance test evaluation.rnFrom those who had discordant test result, 5(1.4%) had false positive reports and 7 (2%) had falsernnegative reports that were corrected through the algorithm on the final result. In the onsite checklist,rn93(26.7%) had safety Manual at their working area where 255(73.3%) lack of safety Manual at point ofrncare. Regarding check up of expiry dates of the kits, 268(77.0%) doesnâ€™t checked expiry dates of test Kitsrnwhere 80(23.0%) of them checked expiry dates of the kits. 308(88.5%) of non laboratory professionalsrnwere managed data of quality elements of Registrations book contents and 155(44.55) non laboratoryrnprofessionals were lack of personnel trained on internal quality control and External quality assurance.rnStatistical analysis by multi variable logistic regression indicated that, profession AOR 0.057(0.0060.579)rnrn(95% CI), P=0.015 and Transfer right amount of sample AOR 51.799 (6.929-387.235) (95%CI)rnP=0.001 were significantly associated with non-acceptable rapid HIV proficiency test result. rnConclusion: HIV rapid testing sites had (96.6%) performance score. False negative and false positivernresults need attention since misdiagnosis leads to psychological, social and economic disturbances to therncommunity. Therefore, immediate intervention is needed based on identified findings. Less experiencernnon laboratory professionals shown lower Proficiency performances so this gaps might be minimized byrnfacilitating training on HIV rapid testing.