Knowing your HIV status is crucial if you want to protect yourself from AIDS. HIV testing, in fact, is being promoted as an integral part HIV prevention, treatment and care efforts by the United States Center for Disease Control and Prevention (CDC). Recent advances in medical science have made it possible for you to get tested for HIV in the privacy and ease of your home. Here are some facts on HIV testing in the U.S and how to get it done at home.
As part of its AHP or Advancing HIV Prevention initiative, the CDC has made HIV testing mandatory for certain groups of population like blood and organ donors, military applicants and active duty personnel, newborns in at least two states, prison inmates under certain conditions and immigrants1. Apart from CDC recommends that routine HIV testing be done for all pregnant mothers, infants whose mothers have not been screened and people indulging in high-risk behavior. You should get yourself tested for HIV if you have:
- Had unprotected sex with someone infected with HIV
- Shared injection or drug needles and syringes
- Had a sexually transmitted disease like gonorrhea or Chlamydia
- Received blood transfusion or blood clotting factor between the years 1978 and 1985
- Had unprotected sex with anyone who has done any of the above things.
If you think you may have been exposed to HIV, get yourself tested for the virus without delay. Testing sites in the US include free standing HIV testing and counseling centers, health departments, hospitals, private doctors’ chambers and STD clinics. However if you are hesitant about approaching a testing center in person, you can get yourself tested for HIV at home too. Privacy and confidentiality are the main reasons why more and more people prefer to go for home testing to see whether they are infected with HIV.
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According to the US Food and Drug Administration, there is only one approved and legally sold home-testing system for HIV in the country2. This sole FDA-approved product is a kit marketed as either “The Home Access HIV-1 Test System” or “The Home Access Express HIV-1 Test System” and can be bought at pharmacies like Drugstore.com, by mail or online. The home-testing kit is manufactured by Illinois-based Home Access Health Corp.
The FDA-approved Home Access System is actually a home-collection test system which allows you to test yourself for HIV in the privacy of your home. To go about it, you will have to collect your blood sample and then mail it to the laboratory for professional testing. The test itself may take an hour to do since it includes time needed to dry the specimen and package the sample in order to send it by mail. Moreover there is a good deal of reading material involved. So if you plan to do the test at home, make sure that you have around a couple of hours’ undisturbed time in your hands. While mailing the sample you will need to use a PIN or Personal Identification Number which will allow you to send the sample anonymously and also enable you to get back the result without your identity being revealed. However it is important to remember that no test kit allows the consumer to interpret the result at home.
The Home Access System is a home-testing kit which checks for the presence of antibodies of only the HIV-1 virus, the most common virus responsible for AIDS. The kit does not have the ability to check for the antibodies of the less common HIV-2 virus. Like most other HIV tests, the FDA-approved Home Access System also confirms an HIV infection based on the presence of antibodies to HIV that begin to be produced once the virus enters the body. However the rate at which individuals infected with HIV produce these antibodies vary from one to another.
If the HIV test is conducted during the “window period” of an infection, the result will be negative. The window period is the time from moment an individual incurs the infection till the time the infected person’s body produces enough antibodies to be detectable by a test. According to the FDA’s Center for Biologics and Research, the infected body may take anything from two to eight weeks, with an average of 22 days, to produce enough antibodies that can be picked up by a test. Most people develop antibodies within three months of an HIV infection but in rare cases it may take as long as six months to develop detectable antibodies to HIV. So it is important to remember that a negative HIV test result within six months of exposure to infection does not necessarily mean absence of HIV infection. This is why repeat testing at 12 weeks and 6 months is highly recommended.
The Home Access System also offers both pre- and post-test counseling for users. This counseling is strictly confidential and anonymous and can be conducted through printed material or over the telephone. Moreover it offers the users with a simplified interpretation of the test result.
Here are a few pros and cons of using the home-testing kit for HIV:
The main advantage of home-testing for HIV is its confidentiality. A person who is scared about being seen in a clinic can do the test without anyone else having to know about it. He or she can do in alone, in the privacy of home.
Again these tests are easily available at stores or can be bought through mail and the internet which can be a convenient alternative for those who do not have access to local clinics or are home-bound due to disabilities.
Most importantly the FDA-approved home testing kits are as accurate as the HIV antibody tests conducted at clinics and hospitals.
One of the drawbacks of HIV home-testing is it is rather expensive when compared to the free or low-cost testing offered at public health department, hospitals or even some private clinics. The FDA-approved testing kit may cost as much as $50 and therefore may be unaffordable for some people.
The confidentiality offered by the home-testing system is not foolproof. If you order the kit it by mail or phone, you have to give an address. Again if you are paying for the kit with your credit card, anyone reading your credit card statement will be able to see that you purchased a HIV-testing kit. Moreover if someone gets hold of your test PIN, then he or she can obtain the result without your knowledge.
An important disadvantage of home-testing is that it bypasses partner notification which is routinely done by public health departments across the country. Partner notification is an anonymous way of telling an HIV positive person’s sex/needle-sharing partners that they have been exposed.
The HIV home-testing system requires the user to read and understand the accompanying material thoroughly. For users not comfortable with the language, this may be a problem. Also some people may be squeamish about a fingerstick used to draw blood for the test.
HIV home-testing like any other medical procedure has its own pros and cons. However the important thing is that the FDA-approved testing system is 99% accurate beyond six months after potential exposure to the infection and hence should be the first line of action by anybody who suspects that he or she has been infected.
If you have a positive result for HIV test by the Home Access System, it is necessary that you get it confirmed by a more sensitive test like the Western Blot or PCR (Polymerase Chain Reaction) test conducted at a professional healthcare setting like a hospital or clinic. You can also get a rapid antibody test done which will give results within 20 minutes. These tests are run where the sample is collected and can be only interpreted and confirmed by trained professionals. Occasionally a person who has not been infected with HIV may also get a positive result with the home-testing system. This is known as a biological false positive test and may occur with tests for other sexually transmitted diseases too. This is yet another reason why you should get a confirmatory test done if your home-test for HIV is positive.
The importance of HIV testing cannot be overemphasized in a time when the prime need is to stop the spread of the infection. According to statistics provided by the Henry J.Kaiser Family Foundation in 2004, of the 850,000 to 950,000 estimated people living with HIV/AIDS in the US, as much as 25% are not aware that they are infected3. This is a cause of great concern since people who are not aware that they are the carriers of the infection will not only keep infecting others but also lose valuable time in seeking treatment for their own condition. Yet another statistic4 reveals that among all those who tested positive for HIV at CDC-funded sites in 2000, almost a third or 31% did not come back for their test results.
In such a situation, HIV testing becomes crucial for containing the spread of the infection as well as for early treatment for the disease. Early detection of the infection can vastly reduce morbidity and mortality for HIV infected people and improve the quality of the lives of those suffering of AIDS. Thus if home-testing systems can contribute to a wider practice of HIV testing, it should be encouraged. However you should be wary of advertisements in print and especially on the internet that falsely claim users of their product can conduct the test and get results at home within 15 minutes. These products are not only being illegally sold but can pose a danger to your health. So go ahead with a home-based HIV test if you believe that is a better option than the clinic-based ones. Only be careful to use FDA-approved home-testing systems and follow up with medical care and counseling should you need it.
1. Kaiser Family Foundation, Survey of Americans on HIV/AIDS (conducted March 1 – May 11, 2004).
2. FDA Consumer Update, Posted January 29, 2008.
3. Kaiser Family Foundation, Survey of Americans on HIV/AIDS (conducted March 1 – May 11, 2004).
4. Kaiser Family Foundation, Survey of Americans on HIV/AIDS (conducted March 1 – May 11, 2004).