Are People Able To Understand Test Instructions And Use Self
A review identified 25 studies in which people used self-tests, with their results compared with those of a healthcare worker testing them at the same time. The original studies were done in a mix of North American, African, European and Asian countries. Fifteen studies used oral fluid-based tests, six used blood-based tests and four used both oral and blood specimens. Of note, several studies were evaluating professional assays that had not been adapted for use as self-tests performance could be better in commercially marketed tests.
The researchers found that most people could reliably and accurately use rapid tests. Using a statistical approach known as Cohens kappa in which 1 represents perfect agreement between the results of a self-tester and a trained health worker and less than 1 represents less than perfect agreement, results were highly concordant. The Cohens kappa was 0.98 in studies in which users first received a demonstration of how to do the self-test or to interpret its result. In studies in which this was not provided, it was 0.97. This means that in only a small minority of cases the self-tester and the healthcare worker got results that were different from each other.
Basic information on testing
Where Can People Find Free Hiv Testing Locations
The CDC maintains a list of HIV testing locations for people who want to find out whether they have contracted the virus. This National HIV and STD Testing Resource can be accessed at . This site includes the ability to search for free testing locations as well as locations that provide rapid tests. Some clinics only provide HIV testing. However, sexually transmitted diseases clinics routinely provide HIV testing along with testing for diseases like chlamydia, gonorrhea, syphilis, and herpes.
Who Can I Talk To If Im Worried
Its always good to have someone you trust on hand to talk through your emotions and worries while you wait for the result. You might also want to have a trusted friend there with you when you get your results back.
If you take a postal test and your result is positive, in most countries when you are informed of your result you will also be put in touch with an HIV clinic in your area.
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How Effective Are Home Hiv Tests
There are some concerns regarding the accuracy of an at-home HIV test. One study compared the results of the two types and concluded that tests given by a healthcare professional were 99.3% accurate, whereas self-administered tests were 92.9% accurate.
The OraQuick At-Home HIV test has been approved by the FDA, as it meets their standards for accuracy. However,evidence shows that about 1 in 5,000 of these tests resulted in a false-positive, and 1 in 12 were false negatives.
Generally speaking, an at-home HIV test is considered to be about as accurate as a rapid test at the doctors office if it is conducted correctly. However, they are slightly less accurate than a 3rd or 4th generation antibody test.
One reason that the test results from at-home HIV tests may not be entirely reliable is due to the testing process. You would need to follow the instructions perfectly to ensure an accurate result. There are far more variables when it comes to at-home testing compared to a healthcare clinic. If you miss a step or accidentally compromise the sample, you could have a false result.
Sensitivity And Specificity Of Hiv Self
Our study suggests that a HIV oral-fluid self test has markedly better accuracy compared to a blood-based self-test in Singapore. In a previous study by our group, blood-based self-testing had a of 0.277. Out of 350 self-tests conducted, 197 were invalid in the prior study. In our current study, the value for inter-rater agreement comparing self-testing to healthcare worker testing was 0.97 . This suggests that, in Singapore, participants are much more able to perform oral fluid sample collection compared to finger-prick based sample collection.
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What The Findings Tell Us
From the point of view of specificity, the figures confirmed that the incidence of false positives remains extremely low, even with the earlier generation tests.
The figure only worsened when retesting bloods from the acute stage infections. Of the 58 samples tested, the 3rd generation rapid tests achieved a sensitivity of only 5.2 percent to 25.9 percent, meaning that the majority of such infections would be missed using these rapid, antibody-based tests.
Even the 4th generationDetermine rapid antigen/antibody test was able to identify only half of the acute infections despite having an estimated sensitivity of 96.6 percent and specificity of 100 percent. According to the UCSF researchers, the Determine worked best during acute infection when the patient’s viral load was over 500,000.
Not surprisingly, the lab-based ARCHITECT combination antigen/antibody test performed best. With an estimated specificity of 99.1 percent and a specificity of 100 percent, the tests were able to identify nearly 90 percent of acute infections.
What Is The Cost Of The Rapid Hiv Test
The cost for the rapid HIV test, whether it uses oral fluid or a finger-stick blood sample is about $8 per test for public health officials and $8-$60 for other organizations. Most insurance plans now cover HIV testing.
There are several rapid tests available which can be done on either whole blood from a vein or finger stick, or oral fluids collected on a special swab. Many of these tests also can detect HIV-2, which is a different virus than HIV-1.
HIV-1 is the retrovirus that typically causes AIDS and is the HIV type most prevalent in most of the world, including the United States. If a person has antibodies to HIV-1, it means that he or she is infected with the HIV-1 virus that causes AIDS.
HIV-2 is a virus found primarily in western, sub-Saharan Africa. HIV-2 is rare in other parts of the world, but it has been reported sporadically in many locations. It is believed to be spread by the same methods of transmission as HIV-1. If a person has antibodies to HIV-2, it means that he or she is infected with the HIV-2 virus.
Testing for both HIV-1 and HIV-2 is important, particularly in people who may have acquired their infection in West Africa or from someone who may have links to that area. Much of the HIV testing currently done in the United States, including the rapid oral test, detects both HIV-1 and HIV-2 .
Available rapid tests include the following:
Third-Generation Tests
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What Do The Test Results Mean
There are three possible test results:
1) Negative . The test did not find any evidence of HIV infection. You probably dont have HIV .
2) Reactive . The test assay has reacted to a substance in your blood. This does not necessarily mean that you are HIV positive. It means you need to take more tests to confirm the result. These extra tests are best done at a healthcare facility where they have access to the most accurate HIV testing technologies.
3) Indeterminate, equivocal or invalid. The test result is unclear. Another test needs to be done.
Is Hiv Testing Necessary For Pregnant Women
HIV testing is critically important for pregnant women. HIV testing is recommended at the beginning of each pregnancy during prenatal care. If any HIV risk factors are present or there is a high incidence of HIV in the population, testing should be repeated in the third trimester. There have been enormous advances in the treatment of HIV-infected pregnant women. With proper management, the probability of transmitting the virus to the fetus is less than 2%. Without proper management, the risk of transmission is as high as 33%. Because undiagnosed HIV is so common, it is necessary to test all pregnant women. It is strongly recommended that all children born to women with HIV also be tested.
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When Is A Good Time To Test For Hiv
Testing to see if you have HIV should be done at least after 3 months. Before the 3 month mark, the testing is not that accurate. If you feel that you have been exposed, please refrain from exposing others until there is an adequate amount of time to test. However, there are some studies have shown that the at 4-6 weeks after exposure some people will have enough antibodies built up to test positive. At the 3 month range, most people will have enough antibodies to test positive. Waiting for an ample amount of time from exposure is necessary for the saliva test to pick up the antibodies.
According to the CDC , there are close to 20 million new cases of STD infections per year, with Chlamydia infections being the most reported. And that is not counting all the people that have sexually transmitted diseases and do not know it since they have not been checked, and they are showing no sypmtoms.
STDs are a serious issue, if you are or have been sexually active, then you could have been exposed to not only HIV, been any of the other most common STDs like Clamydia, Gonorrhea, Syphilis, Genital Herpes, Hepatitis A, B, and C. So, its a good idea to get tested for all the most common STDs to be on the safe side. The downside with Oraquick is it only tests for one thing, HIV.
You can also find home STD test kits that will test for the other STDs mentioned above.
Here are our favorite two options for getting tested for all the most common STDs quickly, privately, and easily
What Should I Do If My At
If you use an at-home rapid HIV test and get a positive result, you should immediately contact your doctor. They will likely recommend that you get a second test from a healthcare professional to confirm the results. False positives are a possibility, so you will want to confirm the tests results.
If you are at high risk of HIV, your best option is to talk to a doctor about taking PrEP. This will protect you from the risk of HIV transmission. PrEP is a medication regimen that can reduce the risk of HIV transmission by up to 99% when taken as directed.
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Implications For Possible Hiv Self
In Singapore, HIV self-testing can be operationalized as an extension of the currently available MOH-approved anonymous HIV test sites. Anonymous test sites are an exception to the legal requirement to report all HIV positive tests to a name-based MOH registry. Unlike provider-based anonymous testing, alternative forms of pre and post-test counseling and linkage to care would obviously be necessary for self-testing. As discussed above, phone based counseling is a potential option. In the United States, the commercial company marketing the FDA approved HIV self-test has committed to maintaining a 24-hour toll-free number providing counseling, advice on test conduct, and referral services for care. This strategy could be used in Singapore.
How Do Hiv Tests Work
There are two basic ways to get HIV test results:
Laboratory tests. For these tests, a technician will take a sample of your blood and test it. Youâll get results within a few days.
Rapid tests. These tests provide results in around 20 minutes. You can get them done in a community clinic or take them at home.
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Other Ways To Get Tested
If youve read this and think that home-testing is not for you, remember there are lots of places where you can get a confidential HIV test, with people on hand to provide help and support.
There is also lots of information available on AVERT.org about testing, living with HIV, starting treatment and much more.
And remember, its always better to know your HIV status. Whether your result is negative or positive, it will mean you can move on with your life, and start treatment if you need to. It will ultimately help protect your health and the health of the people around you.
Whats Next If The Test Is Positive
If a person gets a positive result, a qualified lab should retest the sample to make sure it was not inaccurate or have another sample tested. A positive result on a follow-up test means that a person has HIV.
Its recommended that people who test positive for HIV see a healthcare professional as soon as possible to discuss treatment options.
A medical professional can get a person with HIV started on antiretroviral therapy right away. This is a medication that helps stop HIV from replicating and can help prevent transmission of HIV to other people.
Its important to use condoms, dental dams, or other barrier methods with any and all sexual partners and refrain from sharing needles while waiting for test results or until the virus becomes undetectable in the blood.
Seeing a therapist or joining a support group, whether in person or online, can help cope with the emotions and health issues that come with an HIV diagnosis. Dealing with HIV can be stressful and difficult to discuss with even the closest friends and family.
Speaking privately with a therapist or being part of a community made up of others with the same medical condition can help a person understand how to lead a healthy, active life after diagnosis.
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Who Is At Increased Risk For Becoming Infected With Hiv
People who engage in high-risk behavior like having unprotected vaginal or anal sex, people who have another sexually transmitted infection, people with multiple sexual partners, people who use or share intravenous needles to inject drugs, uncircumcised men, or people who have sexual contact with a known HIV- positive partner are the most at risk for contracting HIV. Additionally, pregnant women infected with HIV can pass the virus to their child during pregnancy.
Home Hiv Testing: Good News But Not A Game Changer
A. David Paltiel, PhD, Yale School of Public Health, 60 College Street, PO Box 208034, New Haven, CT 06520-8034.
Rochelle P. Walensky, MD, MPH, Massachusetts General Hospital, 50 Staniford Street, 9th Floor, Boston, MA 02114
On 3 July 2012, the U.S. Food and Drug Administration approved the OraQuick In-Home HIV Test to detect antibodies to HIV types 1 and 2. This test will soon be available for sale both online and at more than 30 000 retail outlets nationwide. This is the first truly over-the-counter home HIV testing kit, the same test that professionals have used in health care and community-based settings since its approval in 2004. The test provides simple, accurate, in-home detection of HIV infection in 20 minutes using an oral fluid sample .
Public response to the FDA announcement was swift and overwhelmingly enthusiastic. Supporters labeled the approval decision a victory for personal empowerment . National authorities predicted that OraQuick would eliminate the stigma and inconvenience of HIV testing in professional settings, remove barriers to lifesaving care, and help bring the domestic AIDS epidemic under control .
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What Are The Advantages Of A Rapid Hiv Test
The rapid test allows for testing of more individuals. According to the CDC, 1.2 million Americans have HIV, but up to one in eight don’t know it. About 44,000 Americans per year become infected with HIV. This number has decreased recently due, in part, to more testing. Among those who get tested using traditional methods, 31% of those who test positive do not return for their results .
People give a variety of reasons for not returning for their test results. The frequency of each response depends on the population being tested. The most commonly given reasons include the following:
- Fear of a positive result
- Lack of transportation
- Relocating to a new city
- Belief that they are at low risk for HIV and therefore the result will be negative
- Fear that their HIV status will be disclosed to someone else
Significant benefits of the rapid HIV test include the following:
Once important difference between the conventional laboratory test and rapid tests is the ability to detect very early or acute HIV infection. This is done with the addition of an HIV RNA PCR or NAT test. HIV RNA appears in the blood within the first few days of infection. If the antibody test is negative but the NAT is positive, this may indicate that the patient is very newly infected. NAT testing is also used to confirm a positive result of the third- or fourth-generation test. Western Blot testing is no longer routinely used.
Situations In Which Self
Performance of self-tests is poorer in a number of situations. Results may not be accurate.
- In cases of recent HIV infection, during the tests window period.
- In people with diagnosed HIV who are taking HIV treatment. These tests are not a reliable way to confirm that you still have HIV infection.
- In people who are taking pre-exposure prophylaxis or post-exposure prophylaxis . If they acquire HIV, they may have a delayed antibody response, extending the window period.
- When test instructions have not been correctly followed for example not enough blood has been collected.
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Home Testing May Play A Limited Role As An Alternative To Hiv Screening In Professional Settings
Any number of personal considerations may discourage patients from accepting their providers offer of an on-the-spot HIV test: fear, stigma, mistrust of the health system, confidentiality concerns, or inadequate time to mull over the decision. For patients who opt out, home testing may serve as an alternative strategy. Because patients may balk on discovering the retail price of the home test, providers should emphasize that the offer of an on-site option stands.