A welcome move?

A recent move by the US FDA is all set to bring a change to the usual problems associated with HIV testing — late diagnosis, poor treatment and social ostracisation — with a simple home testing HIV kit

How often has an individual shied away from getting himself/herself tested for HIV, simply due to the fear of social ostracisation and the stigma surrounding the very topic? The result – delayed diagnosis, poor treatment chances and a life wasted. But a recent move by the US FDA is all set to change this, or so it seems. The FDA has approved a rapid HIV over-the-counter test kit by OraSure. The saliva test kit, that promises to provide results in as less as 20 to 40 minutes from a swab of the upper and lower gums, is set to be available across 30,000 retail outlets in America later this year.

It may be recalled that up until now HIV testing was carried out exclusively at medical facilities across the world. But with this move, people will be able to test themselves for the virus in the privacy of their homes. According to experts, this also means earlier detection of the virus in patients and thus better chances of treatment. “This home test, is a very good move by the FDA and will facilitate easier and earlier detection of HIV positive patients. Often patients are very reluctant to go to a medical facility to have themselves tested. There is always a chance that the results will be negative and in such a scenario they wouldn’t want others to know that there was a chance of them being HIV positive. But now they can test themselves at home. In case, the test turns out to be positive then they can approach a doctor for further confirmation and treatment,” says Dr Sunitha Narreddy, consultant infectious diseases specialist at Apollo Hospital.

In terms of healthcare too this test comes as a welcome respite believes Dr Sunitha. “People delay getting themselves tested for the HIV virus and it may progress to full blown AIDS, but this test will cut down that risk. It will improve health in terms of long term treatment and also cut down the rate of secondary infections,” she explains.

However, there are still concerns that the test may not always be accurate as clinical trials by the company have shown that it has an 8 per cent chance of false negative or false positive diagnoses.

“A saliva test for HIV has been around for some time now but its sensitivity is not as good as compared to the protein tests that we currently use. This is because the level of antibodies in the saliva is lower so the chances of a false negative result are high. This is one reason the NACO has not approved this test for India. While a home test kit is a good move, it is more suitable for people who are well educated and are better informed about HIV/AIDS,” says Dr Jayacha­ndra Reddy, joint director, APSACS (Andhra Pradesh State Aids Control Society).

He adds, “Along with an HIV test it is also important that the patient is provided counselling. With this home test kit’s failure rate and the fact that there’s no counselling at hand immediately, chances are that the individual may dismiss the risk and continue with the high risk behaviour.”

Furthermore, 60 to 80 per cent of infections in our society occur in the lower economic strata, explains Dr Jayac­han­dra.

“If a person is tested at a centre they are immediately told about the treatment options available to them. With a home kit, chances are they won’t be aware about the options and given their economic status, they might just skip treatment.

“So in our current scenario, we are probably not yet ready to move to home test kits, at least till people are better equipped to take care of themselves,” he says.

Tags: HIV testing, late diagnosis, poor treatment, social ostracisation, US FDA

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