Pros and cons weighed over at-home HIV testing

Oraquick At-home HIV Test

The Food and Drug Administration  approved the over-the-counter at-home HIV test OraQuick®, which is manufactured by OraSure Technologies, on July 3. The test will be available for purchase in the U.S. beginning in October later this year. The test is recommended for persons 17 and older and can detect the HIV virus in saliva in 20 to 40 minutes.

So, what could be better than an HIV test that can be purchased at the local drug or grocery store, for a little more than a pregnancy test?

Let us consider the following, if the test is performed at home and the results are positive, the results are not required to be sent to the Department of Public Health. These statistics are vital for government agencies to determine which demographics are at risk and crucial in developing a game plan for treatment and prevention. An at-home test also means that the person cannot be required to notify their past or current partner(s) of their status.

California’s Health and Safety Code Section 120291 (a) states that “Any person who exposes another to the human immunodeficiency virus (HIV) by engaging in unprotected sexual activity when the infected person knows at the time of the unprotected sex that he or she is infected with HIV, has not disclosed his or her HIV-positive status, and acts with the specific intent to infect the other person with HIV, is guilty of a felony.” With the at-home test, it would be difficult to prove malicious intent and hold a person accountable.

In addition, immediate pre and post-test counseling is not as readily available as it is in the clinical setting. This may delay initial medical treatment. While this test may be fast, convenient, and painless, the test itself is not error-proof when performed outside of a clinical setting. According to researchers, a 99 percent accuracy rate was obtained through a clinical trial, where the test was performed by medical professionals. When the trial was performed in a home setting, there was a 92 percent accuracy rate showing that consumers may not perform the test correctly resulting in false positives or negatives.

Now, let’s look at why at-home testing may help save lives. The cost of the test is still to be determined, but is intended to be affordable with the price expected to be less than $60. The results are quickly available with the test taking as little as 20 minutes. There are no needles involved, only a quick mouth swab. The test kit includes a package insert that contains the 24-hour support center telephone number and website address. The at-home kit also allows for testing as early as three months after a risk event and can be repeated as often as one feels necessary.

If we take into consideration that more people with HIV live in Los Angeles county than any other county in the state, how could routinely checking your HIV status along with always practicing safe sex, not be a good idea when testing has never been more convenient?

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