HIV Tests: Experts Ask if Faster Is Better; Some Fear Treatment, Counseling Will Suffer

The US Food and Drug Administration is expected to approve OraQuick -- a new test that will tell people within 20 minutes whether they are HIV-positive -- soon, although the exact date is unclear. Some doctors praise OraQuick as an easy way to reach high-risk people who might never visit a health clinic -- or return to one to collect their results. Critics, however, say many people actually benefit from a days-long wait for test results because it gives them time to reconsider their high-risk behavior. OraQuick works like a pregnancy test and costs $10 to $15.

Johnn Young, director of prevention at Colorado AIDS Project, said he is uneasy about how the traditional counseling of HIV patients will be folded into the quick-test process. In fact, Colorado officials plan to hold a summit next month with national experts on how to begin using the test in Colorado's clinics and doctors' offices.

HIV prevention officials at the CDC say OraQuick will allow health workers to test a broader spectrum of people. It also may eliminate the portion of patients, 30 percent, who get tested but never come back for the results. Twenty-five percent of those with HIV in the United States do not know they have it, said Rob Janssen of the CDC's division of HIV/AIDS prevention. "We know that when people learn they are positive with HIV, their behavior changes. It really provides an opportunity for someone to get treatment and care," he said.

Proponents say the test is so hard to misuse that AIDS workers and even volunteers could test prostitutes on street corners and men going into bathhouses. But a 1999-2001 study by Dr. John Douglas with the Denver Health Medical Center found that patients who underwent rapid HIV testing were 12 percent more likely to contract an STD later, compared to those who had slower testing. Because the quicker tests also have higher false-positive rates, doctors will recommend patients go through more rigorous blood work to ensure accuracy. Colorado health officials are working to set up a 24-hour phone bank whose counselors will be on hand for people whenever they learn their test result -- even if the result comes from a health van at 2 a.m.

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