In-Home HIV Testing Is Here

On the other hand, there are legitimate concerns to be raised about what happens to someone who uses this kit and receives a positive result, but doesn’t have anyone there to provide help and counseling. OraQuick offers a toll-free hotline people can call in order to speak with a “trained professional.” The company also provides free reading material on their website to help people understand their results. However, we don’t know how likely people are to take advantage of these resources and whether they are as effective as what someone might receive at a doctor’s office or clinic. We know that an HIV diagnosis can be psychologically devastating, so it is vital that newly diagnosed persons get the counseling and follow-up care that they need.

In addition, there is the concern that people may use this test on themselves (or use it as a screening tool for potential partners) and, on the basis of a negative result, choose to engage in riskier behaviors. The problem here is that while the test reportedly produces very few “false positives” (i.e., it is correct 99.9% of the time at providing a negative result when that is the correct decision), it produces a reasonably high number of “false negatives” (i.e., it is only correct 91.7% of the time at providing a positive diagnosis when that is the correct decision). In other words, 1 out of every 12 HIV-positive persons will mistakenly receive a negative result. In addition, if a person with HIV is newly infected (i.e., they were exposed to the virus within the last three months or so), it is highly likely that the test will provide them with a false negative. This is because OraQuick (like the most commonly used HIV tests administered at health clinics) bases its results on the presence of HIV antibodies, which the body does not usually produce until three to six months after the initial infection. As a result, it would be extremely ill-advised to use this test before having sex with a new partner and, on the basis of a negative result, decide to forego protection.

My view is that anyone who has had unprotected sex, sex with multiple partners, or sex with partners of unknown status should be tested for HIV (and if you participate in these activities regularly, you need to get tested regularly). Ideally, this testing will occur in a medical setting where appropriate counseling and resources are immediately available and you can get tested for other STIs at the same time. HIV isn’t the only sexual infection you should be screened for routinely, so please do not look at OraQuick as a substitute for visiting your doctor! That said, if you have concerns about privacy, confidentiality, or embarrassment specific to HIV testing, use of OraQuick is definitely a viable alternative and is far more desirable than not getting tested at all. Lastly, there is nothing wrong with using OraQuick to screen potential partners as long as you realize that the result provided is not guaranteed to identify every HIV-positive partner, nor is it an excuse to stop using condoms with new partners.

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[1] Stall, R., Hoff, C., Coates, T.J., Paul, J., Phillips, K.A., Ekstrand, M., … & Diaz, R. (1996). Decisions to get HIV tested and to accept antiretroviral therapies among gay/bisexual men: Implications for secondary prevention efforts. Journal of Acquired Immune Deficiency Syndromes, 11, 151-160.

Image courtesy of OraQuick

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