Questioning the Efficacy of HIV Home Testing

anxiousA recent article in Poz Magazine about HIV take home tests has me intrigued, and also puzzled. For starters, I didn’t realize that there was even an option to do an HIV test at home. But since November of 2005, the FDA has been considering the possibility of allowing HIV tests to be administered over the counter, similar to a home pregnancy test. The proposed test would be similar to the oral swab test that is now widely available across the country, where the test results are available in under 30 minutes.

One of the major arguments in favor of HIV home testing is that is would increase the number of people who get tested. Did you know that 1 in 4 people who is HIV positive doesn’t know their status?

It’s paramount that more people know their HIV status. About 1.1 million Americans are living with the virus, but one in five doesn’t know it—and these unaware people accounted for half of the 56,300 new infections in 2007. Furthermore, studies show that people who know they’re positive modify behavior so they are less likely to spread the virus.

An OTC test would reach those who don’t have access to a clinic or don’t want to get tested in a medical setting. And the tests would appeal to myriad reasons a person might want to get tested, from the couple ready to take their relationship to an intimate level to individuals about to switch health insurance companies or donate blood and who want to privately confirm their status beforehand to avoid public documentation.

“It’s important to allow individuals to have control over what’s going on with their bodies,” says Yvette Calderon, MD, MS, of Jacobi Medical Center in the Bronx, New York. Having an OTC rapid HIV test, she says, “is just as important as having it within a medical setting. It’s important to have options.”

Additionally,

there’s the question of how OTC rapid HIV tests will affect stigma. “The day we walk into Walmart and see an HIV test on the counter is the day we begin looking at HIV/AIDS differently,” says Thomas Donohue of Who’s Positive, a nationwide youth-focused outreach group. “That alone will break down stereotypes and encourage people to know their status.”

I think these are both major advantages of offering HIV home testing, but I question the efficacy of the tests. For starters, if someone takes a test and has a positive result, they are going to need some counseling and follow up care. I worry that the stigma that kept them from getting tested in medical setting will also keep them from getting the proper follow up care. Secondly, there’s the whole issue of the window of time that it takes for HIV to show up in your system, which can be anywhere from three weeks to six months. If I have unprotected sex over the weekend and get tested on Monday, a negative test result might make me think that I don’t have to get tested for HIV again, which is false. A pregnancy test is pretty accurate – either you’re pregnant, or you’re not. But with the HIV home test, some people would be led to believe that they don’t need to keep getting tested for HIV – which brings me back to the question of follow up care.

I also wonder if HIV home testing will actually increase access. The home tests that currently exist cost $60 a kit, and you have to send a blood sample into a lab. That’s pretty price prohibitive. If we’re talking about increasing access, we’re talking about people who don’t have the 60 bones lying around to pay for that kind of test.

Fortunately, 94% of family planning centers offer FREE HIV testing. Yes, it can be awkward to go get tested. But why not make a day of it? Go down and get tested with your friends, then grab a latte afterwards and dish about the latest celebrity scandal. It doesn’t have to be a big deal.

What’s your take on HIV home testing? Pro? Con? Or somewhere in the middle?

Photo credit: Getty Images

About aj:
Andrew (AJ) is a vehement progressive, youth activist, and reproductive justice organizer. When he's not busy with the movement, you can usually find him dancing in the club or watching trashy reality tv.

Comments

  1. You raised some of my concerns with it, though I would add that swab HIV tests (I realize the one you were talking about is blood) can be messed up by the person taking it–too much mucosal fluid can lead to a false positive result.

    The LA health department has devised a way to do home tests for Gonorrhea and Chlamydia that ties people into care. It seems pretty cool.

    http://publichealth.lacounty.gov/std/docs/kit_press_release061009.pdf

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