Yesterday, the FDA finally granted approval to OraQuick, the first-ever at-home HIV test. The test, which the New York Times calls “as easy as a home-pregnancy test” would make it super-simple to get tested and diagnosed, right in the privacy of your own home. Which is huge for stopping the spread of HIV and AIDS–but is also slightly concerning. How does finding out your status alone, at home, change the experience? Is it better to hear the news from a doctor or counselor?
A simple mouth swab with results in 20ish minutes, the OraQuick truly is quite similar to peeing on the EPT and waiting for the blue circle to show up–except that instead of a pregnancy, it’s diagnosing an expensive, difficult, lifelong disease that requires much medical attention and, perhaps even more importantly, counseling.
The idea of at-home testing, which has been batted around since the 1980s but has always remained controversial, has got doctors and health advocates excited, because it presents great potential for getting more people tested and treated. Without the barrier of a doctor’s office, the theory goes, more people will get tested, and, hopefully, get treatment–or at least, they’ll be more responsible and less likely to spread the disease. Not knowing is by far the biggest contributor to the spread of HIV and AIDS; according to numbers on the OraQuick website, 75% of new cases of HIV positive individuals will change their behavior once they know they’re positive.
Don’t get me wrong–much like the announcement that Walgreen’s was testing out express testing, this is a huge step forward in the fight against HIV/AIDS. Except at Walgreen’s, there’s actually still a human face to look at as those who are getting diagnosed get the news.
How does being at home, alone change the experience of getting diagnosed? Is there something kind of critical about being face-to-face with a doctor or counselor when you get the news? What if those who are diagnosed don’t seek further help, or feel lost once diagnosed?
Last week, I spoke with Gina Brown from the NO/AIDS Task Force in New Orleans, who explained how important it is to have an advocate, a doctor, or a peer counselor around to help newly-diagnosed individuals navigate their new status. Here’s what she told me
It is very important [to talk to someone who is positive]. Because that person has already sat in that chair and walked down that path.
What if there is no chair? What if there is just a bathroom at home, or a hotel room, or another place where there’s no one around to help make complicated decisions, like how to pay for treatment (there are assistance programs to help, which doctors and counselors can help newly-positive individuals find), how to protect their partners, and how to deal with the side-effects of the antiretroviral medication.
If it comes down to not getting tested at all, or an at-home test, then clearly the test wins. But I can’t help but wonder if not being around a person who can hand over a tissue and offer some advice or assistance could be damaging for those who are coming back positive.
The OraQuick will become fairly widely available by October, according to the test’s PR people, and hopefully, it will come with enough information that it will steer newly-positive individuals toward getting further care. Because knowing is important–but so is knowing what to do with your status.
Image via OraQuick