Every month, HIV specialist Theresa Mack, M.D., M.P.H. -- an associate medical director at St. Luke's Medical Group in Harlem, N.Y. -- will answer your most pressing HIV/AIDS questions.
In July 2012, the Food and Drug Administration approved the OraQuick In-Home HIV Test, which lets Americans learn their HIV status in the privacy of their homes. Any intervention that may increase the number of people getting tested for HIV is a great development because the earlier you know your status, the sooner you get into treatment.
Not only does early treatment keep you healthy longer, but studies have shown that those who are in treatment are less likely to transmit HIV to others. If you choose the in-home HIV test, you should know the following important facts:
The in-home kits are the same as the oral HIV tests that are administered by trained personnel. However, oral tests are not as accurate as a blood test that you may get at a doctor's office. With the in-home kits, there is also the chance that you can use the kit incorrectly and get inaccurate results. In a clinical study (pdf) performed by its manufacturer, OraSure Technologies, that compared the results of in-home HIV-kit tests with confirmed laboratory results, one out of 4,903 people who were HIV negative received a false-positive reading when using the in-home kit. Another 8 percent received a negative test result when using the in-home kit, even though laboratory results found them to be HIV positive.
There are a number of reasons that an in-home test can yield inaccurate results:
- The tester may not have followed instructions correctly.
- The tester may have followed the instructions but obtained an inadequate amount of sample on the swab.
- The tester may have read the results too soon. The results should be read between 20 and 40 minutes (pdf) after the test is taken.
- The test could malfunction. For example, an in-home kit should not be used past its expiration date. Kits can also malfunction (pdf) if they've been stored at a temperature outside the 36 to 80 F range.
The in-home HIV test kit (just like any oral HIV test) cannot determine if you are HIV positive. It can only indicate a preliminary positive, which must be confirmed with a blood test by a health-care professional. However, because of stigma and a lack of knowledge among the general community, some people who get a preliminary-positive result may panic and avoid seeking confirmation because they believe it to be a death sentence. Even if a preliminary result is confirmed by a blood test, people living with HIV can live long and well if they get into and stay in treatment.
It may take up to six months after HIV exposure to test positive. An in-home kit (just like the HIV testing in your doctor's office) will not give a preliminary-positive result if HIV infection occurred a week or two before you took the test. It is recommended that you repeat the HIV test in six weeks, three months and six months.
If you have unprotected sex with a partner whose status you don't know or if the condom breaks, you should start PEP, or postexposure prophylaxis, immediately to prevent HIV infection. Go to the nearest emergency room for treatment.
If you get a negative diagnosis from an HIV test, whether taken via an in-home kit or at your doctor's office, you should continue to use condoms if you don't know your partner's status so that you stay HIV negative.
The Basics of In-Home Testing
The OraQuick In-Home HIV test will be available in October 2012 at more than 30,000 retail outlets across the country, including CVS, Walgreens, Wal-Mart and Rite Aid. The price has not yet been finalized, though it is expected to be more than the $17.50 that medical professionals currently pay for it. There has even been some speculation that the price could be as high as $60, since OraSure will be incurring additional costs with the release of the kit, such as those associated with setting up a 24-hour hotline for testers to call after they get their results. The kit may appeal to people who would rather find out about a potential HIV diagnosis alone and to those in rural areas who are unable to easily get to an HIV-testing site.
To use the kit, follow the instructions and diagrams in the package. Apply a cotton swab to the upper and lower gums and place it in a liquid-containing test tube for 20 to 40 minutes. The test measures whether the oral sample contains HIV antibodies, which are special proteins produced in the bodies of people who are HIV positive to fight the infection.
As with a home pregnancy test, one or two lines will appear in a small window on the device to indicate your results. One line would indicate that no HIV antibodies were identified, while two lines would indicate the possible identification of HIV antibodies. Again, this is a preliminary-positive test, and its results must be confirmed by a blood test done by a health-care professional.
OraSure will be providing that 24-hour hotline to answer your questions about HIV/AIDS, counseling and being linked to a medical facility for the confirmation of a preliminary-positive test. Even if your confirmatory blood test is positive, try not to panic. With current antiretrovirals, you can still live a long, productive life.
Tamara E. Holmes is a Washington, D.C.-based journalist who writes frequently about health and wellness.