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Arguments for and against HIV self-testing.

Wood BR, Ballenger C, Stekler JD - HIV AIDS (Auckl) (2014)

Bottom Line: Self-testing for HIV has garnered controversy for years and the debate reignited with the approval of a point-of-care test for over-the-counter sale in the US in 2012.Here, we present arguments for and against HIV self-testing.Arguments against HIV self-testing include: cost limits access to those who need testing most; false-negative results, especially during the window period, may lead to false reassurance and could promote sex between discordant partners at the time of highest infectivity; opportunities for counseling, linkage to care, and diagnosis of other sexually transmitted infections may be missed; and self-testing leads to potential for coercion between partners.

View Article: PubMed Central - PubMed

Affiliation: Division of Allergy and Infectious Disease, University of Washington, Seattle, WA, USA.

ABSTRACT
Approximately 60% of human immunodeficiency virus (HIV)-infected individuals are unaware of their infection, and stigma and discrimination continue to threaten acceptance of HIV testing services worldwide. Self-testing for HIV has garnered controversy for years and the debate reignited with the approval of a point-of-care test for over-the-counter sale in the US in 2012. Here, we present arguments for and against HIV self-testing. The case in support of HIV self-testing contends that: the modality is highly acceptable, especially among the most at-risk individuals; self-testing empowers users, thus helping to normalize testing; and mutual partner testing has the potential to increase awareness of risk and avert condomless sex between discordant partners. Arguments against HIV self-testing include: cost limits access to those who need testing most; false-negative results, especially during the window period, may lead to false reassurance and could promote sex between discordant partners at the time of highest infectivity; opportunities for counseling, linkage to care, and diagnosis of other sexually transmitted infections may be missed; and self-testing leads to potential for coercion between partners. Research is needed to better define the risks of self-testing, especially as performance of the assays improves, and to delineate the benefits of programs designed to improve access to self-test kits, because this testing modality has numerous potential advantages and drawbacks.

No MeSH data available.


Related in: MedlinePlus

Arguments for and against the use of self-reporting HIV tests.Abbreviation: STI, sexually transmitted infection.
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f1-hiv-6-117: Arguments for and against the use of self-reporting HIV tests.Abbreviation: STI, sexually transmitted infection.

Mentions: Proposals for HIV home tests generated controversy in the mid-1980s and debate reignited with the approval of a rapid oral swab kit for over-the-counter (OTC) sale in the US in 2012.8 On one hand, self-tests have the potential to reach persons who otherwise may never seek testing and are at highest risk for HIV infection, to empower users and help normalize screening, and to facilitate mutual partner testing and thus avert unprotected sex between discordant partners. On the other hand, cost and access, possible missed early infections due to the long window period, undiagnosed bacterial sexually transmitted infections (STIs), challenges to counseling and linkage to care, and the potential for coercion remain sharp criticisms to this mode of screening. Here, we review the history and performance of HIV self-tests and the arguments for and against this testing option (Figure 1).


Arguments for and against HIV self-testing.

Wood BR, Ballenger C, Stekler JD - HIV AIDS (Auckl) (2014)

Arguments for and against the use of self-reporting HIV tests.Abbreviation: STI, sexually transmitted infection.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126574&req=5

f1-hiv-6-117: Arguments for and against the use of self-reporting HIV tests.Abbreviation: STI, sexually transmitted infection.
Mentions: Proposals for HIV home tests generated controversy in the mid-1980s and debate reignited with the approval of a rapid oral swab kit for over-the-counter (OTC) sale in the US in 2012.8 On one hand, self-tests have the potential to reach persons who otherwise may never seek testing and are at highest risk for HIV infection, to empower users and help normalize screening, and to facilitate mutual partner testing and thus avert unprotected sex between discordant partners. On the other hand, cost and access, possible missed early infections due to the long window period, undiagnosed bacterial sexually transmitted infections (STIs), challenges to counseling and linkage to care, and the potential for coercion remain sharp criticisms to this mode of screening. Here, we review the history and performance of HIV self-tests and the arguments for and against this testing option (Figure 1).

Bottom Line: Self-testing for HIV has garnered controversy for years and the debate reignited with the approval of a point-of-care test for over-the-counter sale in the US in 2012.Here, we present arguments for and against HIV self-testing.Arguments against HIV self-testing include: cost limits access to those who need testing most; false-negative results, especially during the window period, may lead to false reassurance and could promote sex between discordant partners at the time of highest infectivity; opportunities for counseling, linkage to care, and diagnosis of other sexually transmitted infections may be missed; and self-testing leads to potential for coercion between partners.

View Article: PubMed Central - PubMed

Affiliation: Division of Allergy and Infectious Disease, University of Washington, Seattle, WA, USA.

ABSTRACT
Approximately 60% of human immunodeficiency virus (HIV)-infected individuals are unaware of their infection, and stigma and discrimination continue to threaten acceptance of HIV testing services worldwide. Self-testing for HIV has garnered controversy for years and the debate reignited with the approval of a point-of-care test for over-the-counter sale in the US in 2012. Here, we present arguments for and against HIV self-testing. The case in support of HIV self-testing contends that: the modality is highly acceptable, especially among the most at-risk individuals; self-testing empowers users, thus helping to normalize testing; and mutual partner testing has the potential to increase awareness of risk and avert condomless sex between discordant partners. Arguments against HIV self-testing include: cost limits access to those who need testing most; false-negative results, especially during the window period, may lead to false reassurance and could promote sex between discordant partners at the time of highest infectivity; opportunities for counseling, linkage to care, and diagnosis of other sexually transmitted infections may be missed; and self-testing leads to potential for coercion between partners. Research is needed to better define the risks of self-testing, especially as performance of the assays improves, and to delineate the benefits of programs designed to improve access to self-test kits, because this testing modality has numerous potential advantages and drawbacks.

No MeSH data available.


Related in: MedlinePlus