How effective is at-home HIV testing kit?

Dear Reader,

Getting tested for the human immunodeficiency virus (HIV) can be an anxiety-producing experience and hearing rumors about a past partner’s HIV-status can certainty add additional stress! It’s difficult to say if you’re specifically at risk for HIV, but if you think you’ve been exposed to the virus, the best way to put your mind at ease and to know your status is to get tested. As for your other question, there are currently two at-home HIV test kits that are approved by the U.S. Food and Drug Administration (FDA) and one of them sounds similar to the one mentioned in your question. Keep reading for more information on each one to determine if at-home testing is for you. And, no matter what you decide, it’s good to keep in mind that  getting an HIV diagnosis can carry with it additional mental and physical health concerns, making more accurate, approved tests and the counseling that often comes with them all the more valuable.

There are currently two FDA-approved home tests on the market. The cost for either test ranges from about $40 to $60 and can be found in pharmacies and through online retailers. It’s also worth noting that both tests are completely anonymous (which means that your test results are only associated with a unique identifier, such as a PIN number, not your name or other identifying information). In terms of accuracy, these tests are described by specificity and sensitivity. Specificity refers to the percentage of results that will be negative when HIV isn’t present and sensitivity refers to the percentage of results that will be positive when HIV is present. These percentages indicate if the test is doing its job well (at detecting the presence of the virus), so the higher the percentage, the better. Now, onto the tests:

• Home Access HIV-1 Test System: This test is more than 99.9 percent in terms of specificity and sensitivity and tests for HIV-1 only (the most predominant strain of HIV). A blood sample is used for this test and to collect the sample, users are instructed to prick your finger to draw blood and mail a dried blood sample along with an anonymous personal identification number (PIN) to a lab where trained technicians test it for HIV. Results take about seven days, but there’s an express version of the test if you don’t want to wait as long (the wait is approximately three days and is more expensive). Once the results are ready, users may call a toll-free number and will need to provide her/his PIN to access their results. A positive result with the Home Access test indicates that antibodies were detected in the blood sample. It’s also good to know that the blood sample allows Home Access to do confirmatory testing (to double check your results). This version also provides post-test counseling over the phone.
• OraQuick In-Home HIV Test: This rapid test has 92 percent sensitivity and 99.8 percent specificity and tests for both HIV-1 and 2 strains. Rather than a blood sample, this test detects antibodies uses an oral fluid sample, which is a fancy phrase for saliva. To collect a specimen for this test, users are instructed to swab the upper and lower gums of her/his mouth. Once that’s done, the collection swab needs to be placed in a vial that contains a developer solution. The results will be ready in 20 to 40 minutes for you to read. OraQuick provides a phone number for post-test counseling and referrals for confirmatory testing.

Though both tests may allow you to collect specimens for testing at home, only the Home Access test system performs confirmatory testing if there's a positive result. Why is confirmatory testing advised? This second round of testing will offer assurance that a positive test result is indeed positive or indicate whether a person has received a false positive (i.e., the results wrongly show that a person is HIV positive when they’re actually negative). Moreover, it takes about three months for antibodies to show up in saliva after exposure to HIV. So, if a person is infected and is tested before the antibodies have a chance to develop enough to be detected, the results may produce a false negative (i.e., the results incorrectly show that you’re HIV negative when you are actually positive). So, confirmatory testing (typically done in a clinic or health care provider's office) is likely a good follow-up measure, particularly with the OraQuick at-home test.

Beyond knowing your HIV status, another benefit of getting tested is post-test HIV counseling where you can talk to someone about your test results (no matter if they’re positive or negative) and how that information may impact decisions about your health in the future. Taking advantage of this service by phone with either of the at-home tests or in person in a medical setting can benefit anyone regardless of their test results. An HIV counselor can give advice on ways to prevent the spread of HIV and how to lower the risk of getting other sexually transmitted infections (STI). S/he can also link a newly diagnosed individual with HIV care and treatment services as well.

If you still aren't sure what to do after weighing the pros and cons of at-home testing options, getting tested at a clinic is still an option to consider. You mention that you’re too scared to visit a clinic — is that because of confidentiality concerns? It may offer some relief to know that the Health Insurance Portability and Accountability Act of 1996 (HIPPA) protects a patient’s test results and who has access to their health information. You might want to check out Privacy and STI testing — Who will know my results? in the Go Ask Alice! archives to learn more. If you decide to get tested at a clinic, you can visit GetTested from the Centers of Disease Control and Prevention (CDC) to find the nearest HIV testing location and what services they offer. Some may offer low or no-cost services if you’re worried about how much you might have to pay. If the thought of going alone gives you butterflies in your stomach, think about asking a trusted friend to go along with you. Who knows, they might also want to get tested and may really appreciate the support, too.

Reader, it's always a good idea to get tested if you're concerned about exposure to HIV (and in your case, get tested again for your peace of mind). Beyond knowing your status, though, there are other actions you can take to prioritize your health. These include learning more about how to talk to your partner(s) about STIs and what tools you can use to prevent transmission in the future.

Hope this information helps!