On July 4th 2012, the US HEALTH regulators said they have approved OraSure Technologies Inc's in-home test for HIV, making it the first over-the-counter, self-administered test for the virus that causes AIDS.
HIV home-test a good or bad idea?The Food and Drug Administration gave its green light to the OraQuick In-Home HIV Test, which within 20 to 40 minutes provides results from an oral fluid sample taken by swabbing the upper and lower gums inside the mouth
Clinical trials for the test showed it was accurate 92 percent of the time in diagnosing people who had HIV -- meaning one out of every 12 test results would be a false negative.
False negatives are of particular concern because they could lead HIV-positive individuals to take fewer precautions, raising the danger that they will engage in unprotected sex. The test accurately gave a negative result for those without HIV in 99.98 percent of cases, meaning there would be only one false positive result out of every 5,000 tests. Both of these come with a host of self-explanatory problems.
There are a lot of people who are reluctant to go and be tested. There's a stigma that keeps people in the dark. Overall, we have way too many people who don't know they're infected and they account, people think, for about 70 percent of the new infections each year. "Presumably, if you know you're infected, you'll change your behavior. You'll cut back on the number of new cases.
But while the test is ultimately a good thing, (knowing one’s status), there are serious ethical holes in the test itself.
One problem is accuracy. This test is probably 93 percent accurate. Now that's pretty good, but it means, if you're going test 50,000 people, then roughly (3,500) are going to come out thinking 'I had a negative result and I'm OK, or I had a positive result and I'm infected, when they're not.' So we have right away an accuracy issue. "The test, when you do it at home, doesn't get you into a conversation with somebody about the accuracy of that test. Putting it simply, you need to follow up a positive, early, quick-test result with a blood test that is just as easy to do, but is going to go into a lab and has more accuracy.
Accuracy may also be affected by other factors such as storage of the test kit and the technique as well as probable clear misinterpretation.
There are concerns of misinterpretation of results especially if one is within the so called “window Period”. Window period is usually a period of four to six weeks after infection during which most commonly used tests will show a negative result when in fact one is already infected.
The home test has potential for abuse and misuse. A friend mentioned to me the other day the possibility of partners tricking their friends and testing them unknowingly. For example, a husband comes home drunk and falls asleep and the wife, takes a swab in his mouth and performs a test without the knowledge or consent of the partner. This is a potentially explosive situation.
Picture a scenario: I get a negative test and I'm OK and I think I can keep doing my risky things,. "Risky sexual behavior, risky use of needles. I'm dodging this bullet. Maybe next month, you won't be so lucky."
In short, there's no counseling that comes along with the home counseling. Compares this to a bathroom weighing scale. While a scale can tell you how you're doing in terms of your weight, but to actually make a chance, you need to make changes, which often requires outside help.
HIV home tests are hitting the market any day now which as a disease control expert concerns me. Since HIV home test are not available until now, people had to go to a clinic or doctor’s office to request testing which could be done anonymously. However they were always given information, counseling and resources about HIV both before the test and after any positive results. HIV home test means someone could potentially face devastating news with absolutely no support from anyone. Many people have limited information about the disease in general or the implications. While anyone buying a over-the-counter HIV home test likely understands that it is an STD and a concerning disease, they may not understand the potential treatment options, the symptoms they may experience and the overall course of disease.
HIV home test results may also induce severe stress and I fear that if someone already has poor coping skills or is otherwise depressed, the HIV home test positive result could push someone to suicide or dangerous behavior such as spreading the disease as a form of anger toward others. It is difficult enough to seek out help but in general people are too ashamed to seek help for HIV counseling and medical treatment which means after their HIV home test comes back positive, they are likely to delay treatment and mental health treatment for much too long which puts them at risk for worsening course of illness and extreme stress, depression and emotional problems.
Prior to the HIV home test, a clinic would help patient’s get set-up with a doctor, counseling and support groups. This was key in my view. Some compare HIV home test to pregnancy home tests, which is a valid point. However the stigma with pregnancy is not nearly as severe and aside from younger teen’s being ashamed to tell their parents, they usually are not ashamed to seek medical help. Pregnant women also cannot infect and potentially endanger other people which uneducated HIV patients can potentially do.
So is the HIV home test a good idea? I do not think it is and I worry without the proper funding for education and resources to go along with the HIV home test, we are facing many people in for a shock of their lifetime without any adequate support system in place-I worry about suicide and in this day and age, where HIV is very manageable, suicide due to poor education about the disease is an absolute shame. Some say it will increase the likelihood more people will get tested but on the flip side, it will deter many from getting treated by being able to bypass proper medical clinics.
Having home test may undermine the use of reliable laboratory-based services that have so far helped to deal with the epidemic across the world.
There’s still a lot of misinformation out there about HIV. It’s not a death sentence. It’s a manageable condition. When a medical professional breaks the news of infection to you, they know how to give you hope. When a home test does, you’re left in the dark.
Our system is imperfect. People cannot get testing when they need it. Increased access to testing is a good thing. But improperly administered tests pose new dangers, and I’m concerned that improper information will lead to people acting more recklessly, and risking others to the virus.
Quote: "Having a home test kit for HIV is a bit like relying on a bathroom scale in the battle against obesity,” both can tell you potentially life-saving information. But without counseling, "there is a pretty good chance you will either say 'Thank goodness I did not test positive' and keep doing whatever it is you are doing even if it is bad for you - or test positive and say 'I have a problem and I am so ashamed or frightened I won't do anything at all about it.'" Kizito LubanoTake a fertility test today
On July 4th 2012, the US HEALTH regulators said they have approved OraSure Technologies Inc’s in-home test for HIV, making it the first over-the-counter, self-administered test for the virus that causes AIDS.