HIV Tests Go Private

Consumers reluctant to go to their own doctor or a clinic to be tested for HIV, the virus that causes AIDS, now have a more private option.

Home test kits, sold via telephone order or at pharmacies, are now offered by two companies. A third company expects government approval to market its kit by year’s end.

The Players

Confide, approved in May by the Food and Drug Administration, is available through telephone order ([800] THE TEST) and in pharmacies, including some Thrifty and Wal-Mart stores. The retail price is about $35-$40, and about $50 by phone order, says Jeffrey Leebaw, a spokesman for Direct Access Diagnostics, a subsidiary of Johnson & Johnson, the kit’s developer.

Home Access and Home Access Express tests, from Home Access Health Corp., were approved by the FDA in July. The kits are now available only via telephone order ([800] HIV-TEST), but are expected in California pharmacies by mid-November, says company spokesman Kevin Johnson. Home Access costs $44.95; the Express version is $54.95.

ChemTrak of Sunnyvale, Calif., has also asked for FDA approval to market its home HIV test, says spokeswoman Alene Holzman, and expects it to cost about the same as the other two tests.

How They Work

After getting pretest counseling--either via a brochure or the telephone--consumers prick their finger and place a few drops of blood on special filter paper or a test card.

They send the sample--either regular or express service--in a protective envelope to a laboratory.

At the lab, “it’s the same state-of-the-art testing you would get if you went to your doctor’s office,” Leebaw says.

A sample that is reactive is retested twice.

If samples are reactive in two out of three assays, a more specific confirmatory test, such as the Western blot or the immunofluorescent assay (IFA), is used.

Results are 99.99% accurate, according to Home Access Corp.

The Results

Within a week, consumers can call a toll-free number and enter a code number or personal identification number to find out results. (Or, if they’ve chosen Home Access Express, results are available within three days.)

If results are positive, counselors provide customized support by referring callers to organizations offering medical, social or psychological services.

If results are negative, consumers are urged to repeat the test within three to six months, to rule out infection during the so-called window period--the time interval when people may be HIV-infected but still have negative antibody tests.

“Ninety percent of people will test positive within six weeks of infection with HIV, but in some persons it can take longer, up to six months,” says Dr. Allan Frank, medical director of Home Access Health Corp., citing federal studies. During the interim, consumers are urged not to engage in risky behavior.

The Embarrassment Factor

Because some consumers might balk at purchasing an HIV test kit at the neighborhood pharmacy, both companies offer over-the-phone ordering with credit cards, thus avoiding the “Price check on Aisle 3, home HIV test kit!” scenario.

Consumers buying Confide in stores can choose to take a “silent request form” from the drugstore shelf display to an employee behind the counter or pharmacy, who will retrieve the test and wrap or bag it, Leebaw says.

The Confide kit is rung up on scanners as a “diagnostic kit,” he says.

The scanner display wording for the Home Access kits is decided upon by management at individual stores, says Johnson, and will vary.

The Market

The new home tests are expected to motivate those at risk of contracting HIV who have not yet been tested. According to estimates from the federal Centers for Disease Control and Prevention, more than 60% of Americans at risk for contracting HIV have not yet been tested.

Expert Input

While home HIV tests have been controversial--previously there were concerns over lack of counseling--they are now seen by many experts as a welcome alternative, especially in the wake of findings about the value of early treatment.

“Today, there are a lot more options for early treatment of HIV,” says Dr. Michael Gottlieb, the medical director of the Immune-Suppressed Unit at North Hollywood Medical Center who gave AIDS its name in 1981 while at UCLA. “Anything that makes testing more accessible to people who would not test any other way is a good thing.” He cites convenience, confidentiality and reliability of the new home HIV tests as advantages.

Adds Lee Klosinski, director of education for AIDS Project Los Angeles: “Our concern has always been that people get counseling whether they are negative or positive. If [a home test] is going to help them get tested, great.”

So far, he has fielded few calls about the home test, perhaps, he says, an indication of the growing availability of free and anonymous testing sites in the Los Angeles area.

For test sites or other information, call the Southern California HIV/AIDS hotline, (800) 922-2437.