US approves first over-the-counter HIV home-use test - a good idea?
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US approves first over-the-counter HIV home-use test - a good idea?
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There have been reports that the FDA in the US has approved a over the counter, home testing kit for HIV. They say that it will reach people who might not get themselves tested with their doctor. This
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US approves first over-the-counter HIV home-use test - a good idea?
posted at 5/7/2012 10:49 AM BST
on bmj.com
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*Moderator*
Posts: 1449
First: 7/4/2011 Last: 23/5/2013 |
There have been reports that the FDA in the US has approved a over the counter, home testing kit for HIV. They say that it will reach people who might not get themselves tested with their doctor. This testing kit has apparently been used by healthcare professionals since 2002 - so why not let people self test if it's safe? http://www.bbc.co.uk/news/world-us-canada-18700121 "Dr Jonathan Mermin, director of the HIV unit at the Centers for Disease Control and Prevention, said people who receive negative results should take the test again after three months, because it can take weeks before antibodies to HIV appear." However, what if the test results are positive and the individual finds out they have HIV? Home-testing seems like a good step towards allowing patients to get tested but what about the system of support if the diagnosis is positive? Perhaps they will then go on and contact their doctor, or maybe they might fret about the diagnosis and be reticient to contact their doctor? |
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Re: US approves first over-the-counter HIV home-use test - a good idea?
posted at 5/7/2012 2:41 PM BST
on bmj.com
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Posts: 3045
First: 27/3/2012 Last: 20/5/2013 |
The idea of home testing for HIV apparently sounds good but there are more chances that if the test becomes positive the patients might fret about the result & surely be reticent to contact their doctor! |
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Re: US approves first over-the-counter HIV home-use test - a good idea?
posted at 5/7/2012 3:38 PM BST
on bmj.com
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Posts: 1286
First: 9/12/2011 Last: 23/5/2013 |
Reticence to contact ones Doctor is a concern. But consider this, the literature needs to tell the person to go into their Doctor for a folow up and more bloodwork, Real Lab tests are more accurate, and give better picture of Total blood count, Viral Load, immunoassay, etc. Just like a home pregnancy test, this test is but a cog in the wheel. DuaneF |
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Re: US approves first over-the-counter HIV home-use test - a good idea?
posted at 6/7/2012 1:29 PM BST
on bmj.com
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Posts: 322
First: 12/11/2010 Last: 20/5/2013 |
Overall a very bad idea. The problem with POCT tests is that they tend to be less accurate than a lab test. That means that although they are quite specific [i.e. they don't appear to have many false positives], they actually will produce far more false positives than True positives because the prevalence of infected people [who don't know, and who would be prepared to buy a test] is actually very low. This means the positive predictive value of the test will be very low. In a lab, any positive result would always be confirmed by a second (different) assay - so lab results have very few false positives. A False positive results for HIV = a massive headache for someone to sort out because they will need re-testing... |
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Re: US approves first over-the-counter HIV home-use test - a good idea?
posted at 6/7/2012 2:57 PM BST
on bmj.com
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Posts: 5
First: 25/5/2012 Last: 2/5/2013 |
In Response to Re: US approves first over-the-counter HIV home-use test - a good idea?: The was also resistance to home pregnancy testing, with worries about suicide etc if the result was positive and the woman didn't want the pregnancy. This was overcome by good marketing and consumer education - no-one accepts it is really positive without visiting a doctor / clinic and having it confirmed. So the same should be done for HIV home kits. Besides, seeing a positive result in the privacy of your home may be just the spur that you need to make you seek medical attention. And this is a really good idea for sub-Saharan Africa, where the prevalence of HIV is high so the ppv will be high as well. |
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Re: US approves first over-the-counter HIV home-use test - a good idea?
posted at 6/7/2012 4:44 PM BST
on bmj.com
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Posts: 1286
First: 9/12/2011 Last: 23/5/2013 |
Dr Tim, What about if people wanted a first step available at a drug store? Sure there needs to be a second high quality Lab test done, then immunoassays, and viral loads etc. But surely this test fills a need? Even Labs and Doctors make mistakes. I once had a family member go to the ER for a urinary tract infection, and some idiot Physicians Assistant told this woman she had uterine cancer because of minor bleeding. I kept the person calm because I knew it was a simple UTI, and all was needed was simple antibiotics! The Beedling was caused by wiping. and friction, minor. So bad news often comes from Professionals, and the news is sometimes false. DuaneF In Response to Re: US approves first over-the-counter HIV home-use test - a good idea?: Overall a very bad idea. The problem with POCT tests is that they tend to be less accurate than a lab test. That means that although they are quite specific [i.e. they don't appear to have many false positives], they actually will produce far more false positives than True positives because the prevalence of infected people [who don't know, and who would be prepared to buy a test] is actually very low. This means the positive predictive value of the test will be very low. In a lab, any positive result would always be confirmed by a second (different) assay - so lab results have very few false positives. A False positive results for HIV = a massive headache for someone to sort out because they will need re-testing... Posted by TimReynolds |
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