The HIV Home Test: How Accurate Is It Really?

    In July of 2012, the U.S. Food and Drug Administration (FDA) approved the first home test kit for HIV infection. Individuals can purchase the kit at stores and pharmacies and even on-line to test themselves in the privacy of their homes.

    When the test was introduced, Magic Johnson endorsed the OraQuick test kit as a “Game-Changer” for us, in light of the intense stigma against HIV in the Black and Latino communities.

    So is it really a “Game-Changer”? Here are my thoughts on that. First, consider these two scenarios.

    Scenario 1

    Darnita takes the HIV home test and gets a positive result.  She is terrified and feels she must disclose her status to her boyfriend Dalonte.  Angered by her admission, Dalonte demands a test and threatens to kill Darnita if he too is positive.  His test is also positive.  It turns out that Dalonte was the one who infected Darnita.

    Scenario 2

    Jason takes the test and gets a positive result.  He is devastated. He can’t tell his family and he definitely can’t bear to tell his fiancé.  Even worse, he fears he may have infected her as well. He has just achieved a major promotion but now feels his career is over.  Becoming increasingly depressed, he decides the only escape is through suicide. He begins to plan his death. The test results are actually incorrect.  He has a false positive result. Unfortunately, he doesn’t get a confirmation test. Sadly, he executes his plan (no pun intended).

    Are these scenarios realistic? Think about it and we will discuss it a little later.

    According to research done by the U.S. Centers for Disease Control (CDC), approximately 20-25% of HIV infected individuals do not know they’re infected. The home-test may remove the stigma of getting or requesting an HIV test from your doctor.  This may be a way to help identify these 20% of individuals who don’t know their status and get them into care.  This would clearly be a good thing. There is also good evidence that people who know they are HIV positive may act more responsibly when having sex with others.  They can also access treatment which further decreases their chances of infecting someone else.

    In a recent consultation, a young man communicated to me that he requested his doctor give him an HIV test.  His doctor refused. Refused to test him??? Yes! He would not give this gentleman the HIV test he requested, which, by the way, should be a part of routine medical care!!! This is totally unacceptable and I urged the young man to report this incident to the local Board of Medicine and the Health Department. This incident happened in Washington DC which has long had the highest rates of HIV-infection in the country.  The only reason I can think that this may have happened is because if the young man were to test positive, his physician is not knowledgeable or experienced in the treatment of HIV infection, and he may not want to refer him to a specialist for fear of losing a patient. Now, with the availability of the home test, the young man can test himself.

    For those who may be considering the test, can you answer these questions?

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