Home Testing Past, Present and Future: Lessons Learned and Implications for HIV Home Tests

Abstract

The recent approval in the United States of the first rapid home test to diagnose HIV raises questions about its potential use and impact. We reviewed the existing literature on the unassisted use of home tests involving self-collection and testing of biological samples by untrained users – including existing HIV self-testing studies – to shed some light on what can be expected from the availability of the HIV home test. The studies reviewed showed that most participants could properly perform home tests, obtain accurate results, and interpret them – yielding high correlations with laboratory and health-professional performed tests. Users often had trouble performing blood-based tests. Participants generally understood the need to confirm positive test results. Materials accompanying HIV home tests should emphasize symptoms of acute infection and the need for additional testing when recent infection is suspected. Different home-test-based screening modalities, personalized HIV-counseling resources and HIV home test impact evaluation methods should be studied.

What Should the Ideal HIV Self-Test Look Like? A Usability Study of Test Prototypes in Unsupervised HIV Self-Testing in Kenya, Malawi, and South Africa

“…A review of 11 studies across different contexts suggested HIVST has high acceptability in most instances and increases the reach of HIV testing services with users capable of providing accurate results [3]. Data indicating user preference for oral or blood rapid tests are weak; however, users generally have more difficulty performing blood-based rapid tests [4,5]. In Singapore, of 350 participants using fingerstick rapid tests, almost 90 % found the kit and instructions easy to use and understand.…”

Information, Motivation, and Behavioral Skills of High-Risk Young Adults to Use the HIV Self-Test

“…Specifically, the HIV Self-Test (HIVST) has been publicized for its potential to improve the identification of those who do not know they are infected by increasing access to HIV testing (10, 11). In 2012, the FDA approved the first rapid HIVST (OraQuick test, OraSure Technologies, Bethlehem, PA), allowing an individual to find out his/her HIV status in as short as twenty minutes without the presence of a healthcare provider (12).…”

Approval and Potential Use of Over-the-Counter HIV Self-Tests: The Opinion of Participants in a Street Based HIV Rapid Testing Program in Spain

“…Research groups have also assessed the feasibility of several rapid tests modified as home test kits in different contexts and populations. Although there were differences in performance and supplementary modifications were in many cases pertinent, results were promising enough to make them a plausible diagnostic strategy [23][24][25][26][27][28].…”