Home Run or First Base? – The Rapid HIV Home Test


Home Run or First Base? – The Rapid HIV Home Test

Written by Vivienne Walz

Recently, the United States Food and Drug Administration (FDA) approved the OraQuick rapid HIV test for retail sale in the United States. This means that HIV tests will soon be available in pharmacies, along with pregnancy tests and condoms. Although the test has been approved in the US, there is still much debate about whether it should be sold in Canada. For some people, it’s uncertain whether the test’s benefits will outweigh its costs.

When it comes to rapid HIV testing, either blood or oral fluid can be tested. The OraQuick exam, which is a rapid oral fluid HIV test may cost between $20 and $40. Testing an oral fluid sample, which entails swabbing the gums, gives results in about 20 minutes, all in the privacy of one’s own home. Having the test widely available in pharmacies could help reduce the stigma associated with HIV. The convenience, speed and privacy could entice more people to get tested more often, which will raise awareness and could discourage risky behaviour. This regulated, government-approved home test is a better alternative to the unregulated and potentially inaccurate tests that are currently available on the internet.

However, this rapid HIV test should be only considered a preliminary test, seeing as there can be false positive and false negative results. False positives occur in around 1 per 5,000 tests – but, more alarmingly, false negatives occur in as many as 1 of 12 home tests. As a result of these false negatives, some people may be more enticed to engage in risky behaviour, such as unprotected sex, and this in turn could increase the risk of passing on the virus. False negative results can be due to improper testing technique, but they could also be due to the timeframe of testing. It can take more than 3 months after initial HIV infection for seroconversion to take place and for the body to begin forming the antibodies that the oral fluid exam detects. If an HIV+ person has not yet began producing antibodies, they may believe that they are HIV- and go on to take greater risks. This is why if someone is at risk to have contracted the virus, they should retest often, and additionally, this is why education about the test is so important – people need to be informed that the test isn’t perfect and that they still need to protect themselves.

Another problem with the home test is lack of support for people with a positive diagnosis. There is a 24 hour OraQuick Customer Support Centre with counselors on hand around the clock, but there will still be people who receive a positive diagnosis and find themselves completely alone – which, in extreme cases, could lead to more dramatic reaction. When a positive diagnosis is delivered in a clinic, there is an immediate accompanying support network, while the home test requires people to seek out support for themselves.

Selling the OraQuick exam over-the-counter in Canada will enable people to determine their HIV status with convenience and increased privacy, however, a lack of support and education may come hand in hand with the advantages.

Now to ask you – do you think that making the rapid HIV home test available in Canada is a good idea, or not?

What other issues might need to be addressed before the test is made available in Canadian pharmacies?

What can we do to make sure people with an HIV+ result still get the support and education they need?