Hey there Guys,
Today MX newspaper here in Melbourne did a front page story on a new HIV testing kit that may be offered for sale in local service stations and night clubs. Given the importance of this topic I thought it was important to help bring a little perspective to the idea of home HIV tests, and to also address how rapid HIV testing could be brought to Australia to help eliminate the scary and sometimes painful waiting period involved with traditional HIV tests.
Currently in Australia HIV testing is offered via a visit to your local doctor or sexual health clinic. You get tested and only have to wait a small amount of time before getting your results. One of the main reasons for this current setup is to allow for the important counselling and education that is essential as part of the testing.
If you have never had an HIV test it’s important to understand that, in addition to the blood test, it’s vital to be able to have an open conversation about why you may wish to have the HIV test done in the first place. By talking with a doctor or nurse that has been trained in sexual health, they can help guide your understanding of not only HIV tests but also general sexual health, safe sex, and discuss other tests that may be worth getting done at the same time.
Currently in Australia HIV tests are done via a blood test and depending on where you go there can be a wait of up to one week to before you return for results. Naturally this is a very long time to wait if you are worried, which has been a driving force behind the drive for rapid HIV testing kits.
These tests are available in the USA, with some kits able to offer very accurate test results within 30 minutes.
As reported in The Age newspaper,many Australian’s are keen for rapid HIV testing:
All of the studies that have been done on gay men in Australia that have said, ‘If there was a rapid test would you use it?’, overwhelmingly people say yes. If we introduce it here we would see what we’ve seen everywhere around the world, we’d see rapid uptake.
With many people either reluctant or embarrassed to seek testing with their doctor or local sexual health clinic the set up of rapid HIV testing clinic could increase numbers of people being tested for the HIV virus.
”It’s not just a substitute for standard testing, you actually get people who would not use conventional testing where you’ve got to go to the doctor.”
I was able to see good evidence of this during a visit to San Francisco where a HIV testing facility was set up in a tent as part of a street fair.
Home HIV testing?
One concern I have is with the idea of rapid HIV tests being sold via vending machines. Take for example if these tests were to be sold in nightclubs; what is to stop someone from grabbing a test and using it in front of a potential sexual partner to “prove they are HIV negative”. Given that these HIV tests are checking for antibodies, if the person is only in the very early phase of HIV infection there is a chance that the test may come back negative despite having high levels of HIV virus but no actual HIV antibodies to test for yet.
Without appropriate support and counselling what may happen to the person if the test comes back positive?
Please don’t misinterpret what I am saying. I fully support rapid HIV testing but I feel it’s vital that it’s done in a safe and supported setting that may be a doctor’s room, a sexual health clinic or even a special clinic just designed for these tests. I worry for those people who have testing done at home without someone present to explore why they want testing and what the results may mean. There is also the issue of other tests like chlamydia, gonorrhoea and syphilis. Other infections that are much easier to catch, are very treatable and when found and treated can reduce the rate of HIV infection as well.
The push for rapid HIV tests in Australia
As reported in an ACON sponsored review of community based testing:
The testing included pre- and post-test counselling, support and referral processes. Clients reported high rates of satisfaction with the non-clinical staff (usually peer educators and counsellors), who were empathetic and fitted in well in the community setting.
The key is support, empathy and the importance of having someone there to help explain the testing and be able to guide further testing if results come back positive. This does not need to be done by a doctor or even a nurse. With proper training, caring members of the community can support each other in helping improve health outcomes and increased sexual health testing.
I understand that seeking testing can be scary…certainly the current wait for results does nothing to reduce that fear. It is my hope that with increased lobbying from the health sector, rapid testing will be available sooner rather than later. By having a quick, simple and supported testing facility available the need for HIV tests from a vending machine will be unnecessary.
So tell me, if there was rapid HIV tests available would you use this service? Have you ever visited a rapid clinic for HIV testing? What was your impression? I’d love to hear.
Please feel free to leave your thoughts in the comment box below.
Yours in good health.
Dr George
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