Do you think HIV tests should be sold over the counter, without pre and post counseling?

  • Posted by a hidden member.
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    Jan 04, 2010 6:04 PM GMT
    More and more people are opting to choose, between conventional HIV tests and Rapid, Confidential vs. Anonymous, oral vs. blood,These are some of the topics included with the testing process. Counseling also includes a risk assessment and a personalized action plan.
  • dfrourke

    Posts: 1062

    Jan 04, 2010 7:19 PM GMT

    What other tests other than blood sugar and pregnancy can you buy over the counter?

    My initial thoughts are to keep this test where it will be best monitored and interpreted...with a doctor or clinic...

    If "one in five" women can read a pregnancy test wrong...lord, can you imagine how many dramatic forum posts we'll have from nervous nellies reading their OTC HIV test wrong...

    It is an interesting question, however, and I remain open to hearing what other's think...

    - David
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    Jan 04, 2010 8:36 PM GMT
    I don't have an expert opinion, however an OTC kit might encourage people to get themselves tested, where they otherwise would not because they don't want to visit a doctor or a clinic.

    They sell at home drug tests for:


    People tend discreetly buy these at the self checkout, kind of like people do with pregnancy tests and condoms (at least younger people)...or they steal them.

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    Jan 04, 2010 8:39 PM GMT
    A resounding yes!
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    Jan 04, 2010 8:43 PM GMT
    I'm going to say "no". While some people would be smart enough to know the next steps to take, others would not be.
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    Jan 04, 2010 8:49 PM GMT
    Before answering this, I would need to know more about the amount of counseling that already does or does not occur at the traditional testing sites (STD clinic, private Dr., etc.). Some places test without any counseling at all. Some places only offer counseling after a particular subject tests positive. Some places offer very good informational resources prior, during, and after testing. There's also differences between public and private testing sites. Bear in mind that although HIV testing is not widely available OTC, it is already available, without counseling of any kind, through various private entities. I'm sure that before HIV testing is to become available OTC, there will be studies on the issue I raise where the government and private organizations that would stand to profit from widespread distribution of the test kits try to determine if the benefits of OTC testing outweigh any potential harms. One of the biggest impediments from the government's perspective is that there will be no way to monitor people who test positive under OTC testing.

    I cannot answer yes or no without more information to review and weigh all the pros and cons. It is good to hear different opinions in the debate, but this kind of thing raises public safety issues. Information based on studies and empirical data is needed to corroborate or refute personal opinions. Thankfully, that is precisely the type of review that would take place if it were to happen. (I don't know, but perhaps this is already being debated in the Health and Human Services field).
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    Jan 04, 2010 8:52 PM GMT
    Yes but is the fact some people wouldn't know what to do next a reason to keep them from the people who would? I say YES! The more people who know their status, the better.
  • JockChefJim

    Posts: 373

    Jan 04, 2010 8:59 PM GMT
    I'm going to have to say yes too. I know there are people out there who have had bad experiences with counselors at the being one....and though a bad experience should not allow anyone to not do the responsble thing.....maybe a more confidential way is best for some people. If they show positive, they can always go to a doctor or a clinic and restest......just like I assume women do with pregnancy tests.
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    Jan 04, 2010 9:25 PM GMT
    Home Access Express HIV-1 Test System is available at if you have an FSA/HSA through your employer or insurance provider. Delivered right to your door. No need to even go to the store. Next day results. I think this is still the only FDA approved home test kit. (For anyone who may have been interested in the info.)

    If someone is questioning their status and is able to test at home in complete anonymity without fear (rational or not) of recrimination, then I wholeheartedly believe that should be an option. It is solely up to that person if they choose to pursue an in-clinic test for confirmation and counselling. At least they will have started down the right path to awareness, and if necessary medical care.
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    Jan 04, 2010 9:28 PM GMT
    I am for it if it improves outcomes. In the absence of data, I don't think they will in my opinion.

    Getting better access to free tests, better sex education, and condom distribution do improve outcomes, however.
  • Sebastian18

    Posts: 255

    Jan 04, 2010 9:31 PM GMT
    In short, under no condition would I advocate selling over-the-counter HIV Antibody (rapid) tests under any condition whatsoever, especially without a reliable physician to interpret the results.

    As a disease intervention specialist whose job it is to daily test people for HIV as well as knowing some of the draw-backs of rapid testing (i.e. kits being temperature sensitive, minor likelihood of giving false negatives or no reactivity, etc. ) I couldn't trust the general public to take the same precautions in interpretation as a trained specialist.

    Additionally, without proper counseling who knows what reactions individuals would have and how over-the-counter kits could be used to "blackmail" or discriminate against people.
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    Jan 04, 2010 9:39 PM GMT
    Yep, sell'em OTC. The smart user will still follow-up.icon_cool.gif
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    Jan 04, 2010 9:40 PM GMT
    I don't really care to address the social ramifications which I think an argument could be made for either side of the issue.

    *For me* I can easily say "HELL YEAH!"
    I get tested religiously and as much of a benefit as the counseling has been from the men's clinic and as much as I enjoy visits with my primary care physician, at this point in my life after a few decades of HIV testing I would LOVE to have the convenience of an OTC test.
    In the case of getting a positive, just like going to the doctor or a clinic I would get a follow-up test with my doctor. For myself, information is power and convenience is key.
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    Jan 04, 2010 9:41 PM GMT
    BiGymGuy saidYep, sell'em OTC. The smart user will still follow-up.icon_cool.gif

    Will someone too stupid to get tested by their doctor be smart enough to follow up with their doctor?
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    Jan 04, 2010 9:49 PM GMT
    Anytime a test can be made reliable and cheap it's a good idea.

    Recently, Walmart put forth a HBA1C test for $9.50. Countless folks are now able to get the A1C without spending a bucket of money buying a doctor's tennis court, or BMW. We've seen as much as $480.00 for a A1C.

    It speaks to a bigger problem in this country where we treat drug use / abuse, and often illness, in punitive and criminal way, and in a way that makes it impractical (way too expensive) for many (about 30% who are uninsured) to get the care they should.

    Another example. flex89's Humalog U100 insulin is $108.25 in the USA at Walmart for 10cc. In Canada (from it's $28.25. That jug lasts 10 days. Now, don't tell me Big Pharm needs a extra $80.00 every 10 days to keep Logan alive. That's bullshit. I encourage you to watch the movie "Sicko."

    Yet another example. Syringes, from are $5.25 for 100 count. In a retail setting, they're $30.00. Now, there's such a thing as a reasonable profit, of course, but, that's b.s., too. med-ware won't sell to just anyone that needs syringes, though, because they don't want hassled for doing the right thing. It's that good old Puritan thinking of restricting access. I.e., if you don't sell they can't get them, which, of course, isn't true.

    Our medical system is INCREDIBLY broken.

    There are some things that should be done for the public good, and not on the backs of our sick and injured. Medical tests, supplies, and care, is one of them.
  • Posted by a hidden member.
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    Jan 06, 2010 6:48 PM GMT
    Pre testing includes information on HIV transmission, Why the test is done (treatment, improve outcomes, reduce risk of transmission)
    How the test is done
    What the test tells and does not tell (ie discuss exactly what you are testing for)
    For infections with window periods, discuss implications, advise if and when repeat testing will be necessary.
    Determine when exposure to risk occurred
    Discuss implications of a negative result:
    Discuss prevention - don't let people go away with the idea a negative test somehow confers immunity on them for future risk taking behaviour.
    Reinforce the positive aspects of safe sex practises. Opportunity for further education
    May require repeat test if exposure still within 12 week window period
    Discuss implications of a positive result:
    What a positive result would mean
    Discuss the options for medical treatment and follow-up
    Consider the availability of family or friends who may be available to talk with if the result is positive (support systems)
    Discuss contact tracing and what this means
    Evaluate patient's coping skills
    Risk reduction:
    Stress importance of ongoing risk reduction strategies
    Specifically address any risks identified in history
    Offer follow-up support.
    assess readiness
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    Jan 06, 2010 6:50 PM GMT
    I don't think it's a bad idea. You can still get them at the pharmacy from behind the counter without a script, right? I recall that being the case a few years ago...
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    Jan 06, 2010 6:52 PM GMT
    The otc hiv tests that they have currently. It is not instant results. It is a prepaid package you put your urine sample in and send out in mail and get the results back in a business week.
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    Jan 06, 2010 6:54 PM GMT
    you can buy and hiv test over the counter?

    i dunno if its the smartest thing... its not like getting pregnant.

    doesnt it take up to 6 months to be detected?

    so someone might have a random sex night, buy a kit the next day and be okay and just continue fucking around...