The first rapid home test kit for HIV is expected to be approved in the United States next month, after years of controversy and fears that people who find they are infected may kill themselves.
Approval of the test following a Food and Drugs Organisation (FDA) meeting on November 3 will mark a shift in thinking about HIV/Aids. For nearly 20 years, experts and activists have agonised over tests that allow people to find out their HIV status in privacy but also isolation, without access to counselling.
HIV infection was seen as a death sentence in the 1980s, before medication with antiretroviral drugs took off. Home tests became illegal in the United Kingdom when the HIV Testing Kits and Services Regulations 1992 were passed. The law would have to be repealed for the tests to be imported here. The US passed similar legislation in 1988, but lifted the ban in 1995.
The new kit is as simple as a pregnancy test, and the US FDA seems set to decide that its usefulness in alerting people quickly and privately to their HIV status, so that they can avoid infecting others, outweighs any harm. The rapid test, called OraQuick, analyses saliva and gives a result in 20 minutes. One blue line is good news, but two means the person has HIV, which leads to Aids.
The technology has been around for some time. Eighteen years ago a company applied to license a home test, but there was concern at the impact of the diagnosis, which then looked like a sentence to imminent death by Aids. At FDA hearings, activists handed around obituaries of a man who leapt off San Francisco’s Golden Gate bridge when he received his diagnosis. For years, the activists said tests must be linked to counselling and support.
Today, HIV/Aids is managed so well in most cases that people live normal lives. But with the lowering of fear levels around Aids, people have become less cautious. Cases are rising by 40 000 a year in the US.
Campaigners have shifted their ground. Gregg Gonsalves of Gay Men’s Health Crisis in New York, now believes the test is better than arriving in hospital with pneumonia or cryptococcal meningitis — infections typical of Aids. The home tests are also supported by the Terrence Higgins Trust in the UK.
In South Africa, the Department of Health says it does not support home test kits.
”We don’t have it and we don’t encourage it. People need to be counselled. They need to understand the consequences. If you test HIV-positive, it doesn’t mean the end of the world. If you test negative, it doesn’t mean you are immune. It means that you must take care of yourself and live a healthy lifestyle,” said Solly Mabotha, director of media and public information at the department.
”If you do the test at home and hide away so you are the only one who knows you have HIV, that doesn’t work, because our view is that you need people to advise you on what you want or need to do.
”Maybe you have to change your diet, and you have to find out if you need medication or not.
”It doesn’t make a difference to us that the US [is set to] approve these home tests. There are facilities to do a test at and we encourage people to go there.” – Guardian Unlimited Â