Sex Week: Home Tests for HIV?
Are over-the-counter HIV tests accurate or reliable?
The Food and Drug Administration approved home HIV tests after a great deal of debate. When the first tests were submitted for regulatory scrutiny, there was much concern about accuracy. On top of that, the FDA and some AIDS activists worried that people would not get the psychological help they needed when they learned the results of positive tests. This information can be extremely upsetting. People who are tested at clinics or by their doctors always receive their results in person - from a trained professional. Counseling is critical to understanding what the results mean, learning how to cope with them, and finding out about treatment (if infected). Many people feel there is just no substitute for face-to-face counseling.
The FDA ultimately decided that the tests were highly accurate, assured patient anonymity, and provided appropriate counseling. It was thought that this option would allow more people to be tested and to know their HIV status, which in turn could stem the tide of new infections. In one survey, many people said they preferred the home test to going to a clinic. Men of color in particular said they were more likely to use a home test kit. And according to the Centers for Disease Control and Prevention, 85 percent of people tested in clinics don't get counseling with the results.
If it's more convenient and you decide you don't want to talk to someone in person, I think a home test is fine. Just make sure you do make use of the counseling available by phone.
Here's how the test works: You start by reading the instructions and pretest counseling booklet, then you prick your finger with a fingerstick in the kit and collect a blood sample. You drip three drops of blood onto a test card marked by a special identification number, and you mail it to a laboratory for HIV-antibody testing. Seven days later, you call a toll-free number, day or night, for the results. If the results are negative, an automated voice tells you so. If they are positive, you talk to a live person about them, what they mean, and how to get medical care.
It's very important to stay on the phone and talk to the counselor once you get the result. Realize that false positives do occur, so if you test positive, you should get tested again. The lab will do a second test by the same method, and if that one's positive, will perform a more sophisticated test called the Western blot.
If you test positive, the counselor will tell you about a number of drugs that lengthen life expectancy. You can also find out about medical, psychological, and legal services available to you.
The standard Home Access Test System, which includes pretest counseling, costs $29.95 for results by phone within seven days. The "express" Home Access test is $49.95 for results within three days. Call (800) HIV TEST (448 8378) for more information. Also, a company called Beacon Diagnostics Inc. is marketing a test that looks for HIV antibodies in saliva and mucosal fluid instead of blood. You know the results within 15 minutes. Right now the test is being sold through health-care providers in the Caribbean, Cypress, and South Africa. Beacon has applied for US approval, but that might take a couple years.
Also, keep in mind that a negative result doesn't mean you never have to worry about HIV again. If you're sexually active in a nonmonogamous situation, or if you inject drugs, it's important to get tested regularly. There is a "window" period of up to six months where you may be infected without the virus showing up on a test.
And always use a condom to protect yourself during sexual intercourse. If you do inject drugs, use a clean needle.