Home Testing for HIV -- Reading the Lines in Do-It-Yourself Test

PHOTO: An OraQuick ADVANCE Rapid HIV-1/2 Antibody Test is shown in this undated photo provided by OraSure technologies.
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Dan Nainan had never heard of a home test for HIV until a prospective girlfriend insisted that he take one. Apparently, she didn't trust him.

"I'm not some sleaze bag, but she's really suspicious," said Nainan, 31, who works as a comedian. "I'm like, 'Come on, you're kidding me.'"

The test became a sticking point in their budding relationship. "I didn't feel I had anything to be worried about," Nainan said, "but she didn't want to proceed."

He finally gave in and took the test his girlfriend foisted on him, certain he'd test negative. He swabbed his gums -- the test works on saliva -- put the test swab in a test tube and waited as his girlfriend grilled him about his sexual history.

"It was a bit uncomfortable," Nainan said.

Ten tense minutes passed as he watched a deep-pink line appear slowly in a tiny window on the testing device. He prayed it wouldn't be joined by a second line signaling a positive result, and wondered what he'd do if it did emerge.

"I felt like I was taking a pregnancy test," Nainan said.

Do-it-yourself home testing for HIV, the virus that causes AIDS, has arrived.

The OraQuick In-Home HIV Test -- the only one approved for over-the-counter use by the Food and Drug Administration that captures testing and results in one sitting -- hit drug-store shelves two months ago. An earlier HIV home test -- called Home Access -- required a user to prick a finger with a spring-loaded lancet, collect a drop of blood on a test card, mail it to a lab and call in one to seven days for the results.

"This was actually quite easy and painless," Nainan said of the OraQuick test. "It's so much better than what you used to have to do."

Aimed at those who might have avoided getting tested in the past either out of, fear, stigma, worries over confidentiality or inconvenience, the new home test has been hailed as a breakthrough.

"It's hard not to be fully enthusiastic about the test," said Dr. Myron Cohen, director of the Institute for Global Health and Infectious Diseases at the University of North Carolina at Chapel Hill. "Everything we do to increase testing has to have some degree of benefit. By identifying and treating people early, we preserve normal life span and excellent health and reduce contagion."

But the new home test, which sells for about $40 and can also be bought online, has generated its share of hand-wringing, too.

"We generally like this thing," said Dan Tietz, executive director of the research and advocacy group AIDS Community Research Initiative of America, or ACRIA. "It decreases some of the barriers to testing. It kind of puts HIV in front of people, but there's a bunch of cautions."

For one, there's what Tietz called the "freaking out by themselves problem" -- for the first time, there's no live counselor present -- not even a voice over the phone -- to deliver the results, offer support and make referrals.

Nainan tested negative for HIV, as he expected he would. Despite some sweat as he waited out the 20 minutes staring at the test window, "I really wasn't nervous," he said.

But for home-testers less certain of their HIV status, or who receive an unexpected result, the do-it-yourself route could be overwhelming, Tietz said. "I think about a young person with very little experience with the health care system who might pick up this test," he added.

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