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Saliva testing for HIV

Jun 28, 1996

Do you feel a home HIV saliva test kit would be a positive or negative in slowing the spread of HIV.

Response from Mr. Sowadsky

This is really a difficult question to answer. Home testing has just started in 2 states (Florida and Texas) using a home blood test, and it's hard to predict if it will have any effect at slowing the spread of HIV. Only time will tell. Home testing (whether it be using blood or saliva) has it's pro's and cons.

PROS: A person who's scared about being seen in a clinic can do the test without anyone knowing about it outside their home. They may feel more comfortable doing the test alone.

CONS: Getting test results over the phone can be very difficult, especially if the test was positive. A person can just hang up and never hear all the counseling and information they need to hear. Test counseling is best done face-to-face, and is most effective this way. Using home testing, if a person is positive, there is no way to do partner notification (letting a persons sex/needle sharing partners know they've been exposed). Partner notification is routinely done by local health departments around the country for HIV and other Sexually Transmitted Diseases (STD's). Home testing would bypass this important, and proven, preventive health measure. Also, some states require by law, confidential testing (no anonymous testing) and reporting. In many states, HIV is a reportable disease to local health departments (like many other infectious diseases). Reporting helps ensure all infected people receive adequate follow-up care. It also gives accurate statistics as to the scope of the epidemic, and where it's going. It's also critical in terms of funding issues, since the federal government gives each state HIV/AIDS funds based on their reported number of cases. Without reporting, some states may lose critical federal funding to serve those infected with HIV. Home testing is also more expensive. Testing through local health departments, and some private agencies, are free or low cost. Home test kits are expected to cost $40 or more. Whether this increased cost will keep high risk people from buying the kit is still not known. Another issue to be dealt with is confidentiality. In a home test kit, a person has a test ID card that is used to identify the specimin. Anyone who has the number can get the test result over the phone. The person whose being tested has to make sure that nobody sees the card. Otherwise, any person who sees the card or the number can get that other person's test results. So it's important that a person getting tested at home doesn't leave the ID number lying around the house, where other members of the household can see it. As you can probably tell from my answer here, I'm not a proponent of home testing as it stands in it's present form. The test itself is as accurate as any other antibody test. Home testing is however an alternative for some people. It's up to the public to decide just how well home testing will be as an option. Overall, when we're talking about home testing, and whether it will slow the spread of HIV, it's too soon to tell. Whether a person wants to get tested at home, through a local clinic, or through their private physician, it's imperative that pre- and post-test counseling be included with the test, so a person can learn about ways to prevent themselves from becoming infected with this or other Sexually Transmitted Diseases (STD's).

If you have further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).

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