The face of HIV has changed enormously in recent years. People living with HIV who are receiving appropriate medical care can live almost as long as people who do not have HIV.
Testing and treatment are still essential, however. The Centers for Disease Control and Prevention (CDC), now recommend that everyone from age 13-64 have at least one HIV test as part of their routine healthcare.
A home HIV test kit makes it possible for individuals to access this critically important health information, at their convenience and while preserving their privacy.
Two HIV home testing options have been approved by the Food and Drug Administration (FDA) and are available in the United States (U.S.). These are the Home Access HIV-1 Test System and the OraQuick HIV test kit.
Home Access HIV-1 Test System
This was the first home HIV test kit, approved by the FDA in July 1996. This test requires a blood sample, which is then sent off to a lab for processing, via the mail.
In order to use this HIV test kit, an individual must first call a toll-free number and register using an anonymous code. Pre-counseling and a brief, anonymous interview about demographic data are conducted. Then the individual collects their blood sample and sends it off to the lab for processing.
The results will be available the working day after the lab receives the blood sample.
In order to get the results of their tests, people call the same toll-free number again and use their anonymous codes. Since the manufacturer double-checks the results before they are made available to users, additional immediate testing is not usually required if the result is negative.
If a person receives a positive test result, they should make an appointment with their doctor as soon as possible.
OraQuick HIV Test Kit
First available for sale in the U.S. in April 2013, this HIV test kit is much newer and provides results in about 20-40 minutes.
Individuals collect a saliva sample by swabbing their upper and lower gum lines and placing the swab in the testing solution. When the reaction is complete, users read the results at home.
Positive results are not considered final. Users are instructed to get a follow-up test at a clinic. The manufacturer provides a 24-hour toll-free counseling service and helps individuals with positive results get access to local clinics.
It is possible to find other kinds of HIV test kits online. These versions do not have FDA approval, however, and their test results might not be as accurate.
How effective are they?
The main difference between these two HIV test kits is that the Home Access system is based on the results of blood tests analyzed by professionals in a lab. The OraQuick test is based on the chemical reactions of saliva, as observed by the user.
Both tests are quite effective at detecting negative results, with a 99.9 percent accuracy rate.
When it comes to positive results, studies have found that lab-based blood tests have a 99.7 percent accuracy rate, but the OraQuick method is only 91.7 percent accurate.
This means that almost 1 in 10 people using the OraQuick HIV test kit could have received a false negative result, which means that although the test says "negative," the person is actually HIV-positive.
The reported advantages associated with a home HIV test kit are:
- potential for increased access to HIV testing
- easy to use
The following drawbacks to home test kits have been identified in several studies:
- If the virus is present but the bloodstream does not yet have detectable levels of antibodies for the infection, the results will read as false negatives. The virus can be passed on at this time.
- Reports indicate that when the test has not been carried out by a medical professional, there is a drop in accuracy of detecting established HIV infection from 99.3 to 92.9 percent. This can also lead to false negatives.
- Poor use of the OraQuick test swab on the gum line, due to dentures, or not following directions, can lead to false negatives.
Cost and availability
Purchasing an HIV test kit is fairly straightforward. Both types are available online or at drugstores, without a prescription.
For example, OraQuick is available for purchase online at the company's site. The cost is $39.99, plus shipping and handling, and the company uses unmarked packaging to preserve purchasers' privacy. It can be purchased online or in person at drugstores for around $43.99.
The Home Access HIV-1 Test System is also available online or in person at drugstores for around $59.99.
There are many different reasons why people choose to use a home HIV test kit. Users are frequently:
- individuals with a strong need to keep their medical conditions private
- people living in remote areas
- individuals living in small towns or places where they feel they can't be anonymous
- people without a lot of schedule flexibility
- individuals engaging in high-risk behaviors who have never been tested for HIV
High-risk behaviors that increase one's risk of exposure to HIV include:
- IV drug use
- sharing needles and IV drug paraphernalia
- having unprotected sex without knowing a partner's HIV status
- having unprotected sex with a person who has HIV
- trading sex for money or drugs
It is strongly recommended that anyone who has engaged in any of these behaviors be tested for HIV as soon as possible.
Early symptoms to look out for
HIV symptoms vary widely, particularly in the early stages of the disease. While some people may get sick within a couple of weeks to months of getting infected, others may not notice any symptoms at all.
Symptoms that may appear in the early stages of HIV infection include:
If someone tests positive for HIV with the OraQuick HIV test kit, an additional test is needed. If the test was done with the Home Access HIV-1 Test System, no additional test is needed, however, most medical providers will likely repeat a test with their own equipment.
A positive test means that an individual has been infected with HIV, and the two most important things to think about are how people can take care of themselves and protect others from getting infected.
The following actions can help people with positive results take care of themselves:
- connecting with a licensed healthcare provider as soon as possible, even if symptoms are hardly noticeable
- starting antiretroviral therapy (ART) as soon as possible
- getting tested for other sexually transmitted infections (STIs) and tuberculosis (TB) to address other potential health problems
- taking steps to protect the immune system by quitting smoking, using illegal drugs, or drinking to excess
- seeking help with substance abuse problems
- seeking counseling for support in dealing with the impact of HIV infection
The effects of HIV and other conditions can be minimized if people take the following actions:
- talking openly with a partner about any health conditions before sexual activity, including oral, vaginal, and anal sex
- always using latex condoms or dental dams during sex
- not sharing needles or drug paraphernalia
- taking medications as directed
- discussing the possible use of pre-exposure medications with sex partners who have not tested positive
One negative test result may not guarantee that HIV is not present. Both the Home Access HIV-1 Test System and the OraQuick HIV test kit are based on measuring antibodies to HIV. After exposure to HIV, it takes time for the body to develop enough antibodies to the infection to show up on a test.
This time period is referred to as the window before seroconversion. Seroconversion can take up to 6 months. If exposure may have taken place within 3 months of a negative HIV test, further testing is recommended in 3 months.
Regardless of the results obtained from an HIV test kit, it is important to remember that safe sex practices, such as the use of a condom, can help prevent a range of sexually transmitted diseases.