New do-it-yourself HIV test offers privacy

In an effort to make HIV testing as accessible as home preganancy tests, the Food and Drug Administration has recently approved the first HIV home testing kit.

After almost a decade spent determining the benefits and risks of HIV home testing, the FDA finally approved the controversial over-the-counter home-use specimen collection kit on May 14, 1996. Until now, testing was only available through a health professional.

As many as one million Americans are now infected with HIV, with an estimated 40,000 to 80,000 new infections occurring each year. The national average of college students infected with the HIV virus is 1-in-500. According to Katie Huang, program coordinator for SF State's HIV testing services, approximately 1-in-400 SF State students are infected with the virus.

"It could be because San Francisco has one of the highest statistics or reports of HIV-positive individuals," Huang said. "We are a very urban and liberated campus. HIV has been an issue for this campus since HIV existed."

A recent survey conducted by the National Centers for Disease Control and Prevention showed that only 20 percent of people at risk for HIV infection had planned to be tested by a professional within a year's time, but that 42 percent of people at risk would likely use a home testing and counseling service.

"Two out of three people who are at risk would test if the option such as Confide was offered," said Confide Marketing Director Arisa Cunningham.

The kit uses the same ELISA and Western Blot techniques that are routinely used to diagnose HIV infection in various labs around the country. ELISA is the first test that is performed to detect any presence of the virus. The Western Blot technique is usually used to confirm that the antibodies exist.

"Both tests are very sensitive and very specific, meaning the accuracy rate is very high. I think it's 99 percent accurate," Huang said.

The Confide kit user pricks a finger with a lancet, blots three times on the blotting paper and sends the strip to the laboratory. For test results and post-test counseling, the kit purchaser calls the toll free number seven days after the specimen is mailed in. All results are identified by a 14-digit PIN number.

"Chances are one in a billion will transpose the wrong number," Cunningham said. "We have already tested the process more than a million times."

According to Confide manufacturers, if the entered PIN number is not valid the purchaser has another three chances. If the PIN number is still wrong, the automated operator will tell them to call again when they are more comfortable.

"Dialing a PIN number is like your calling your bank," said Cari Hauck, a sophomore majoring in creative writing. "Sending blood through the mail seems strange. It's scary to think of mistakes or getting the blood sample lost in the mail."

Hauck wishes more funding would be available for free clinics, like the Haight Ashbury Clinic, in order for people to find out results from a real person.

The FDA initially questioned the counseling process. Current counseling consists of a brochure supplied with the kit that explains the implications of HIV testing. A hot line is also available for advice, support, and for directions on using the lancet. Those who test negative are informed of their results by a recorded message while those who test positive are informed by a member of the counseling staff.

"Is it like they're reading off a script like an EMT when you call 911 services?" Huang said. "But this is not bleeding in the head or drowning in the swimming pool, where you follow the same procedures for those kind of problems."

Pablo Long, a graduate student studying French and theater, said it's important to find out results one-on-one and not by the telephone. Health educators are supposed to teach you how to avoid taking risks and give you compassionate feedback, he added.

"Students here should take advantage of the Health Center," Long said.

According to Cunningham, 75 percent of the counselors have a masters degree in psychology or health education. Most have at least six years experience with crisis intervention and suicide hot lines. In addition, the counselors have to be certified every year by taking an examination.

"I could very much hang up the phone and say thank you very much and say I understand my results and later go jump of the Golden Gate Bridge," Huang said.

She added that the whole purpose of getting tested for HIV is to realize you are at risk and HIV infection is a behavior-related issue or problem.

The Health Center offers HIV testing for $9 and focuses on changing behavior. Confide is sold at drugstores for $40.

According to Huang, a lot of the time products like Confide are more expensive than clinical tests because of the costs involved in shipping and support services that attempt to ensure privacy.

"I think because it's something new, something convenient and also Federal Express is involved," she said.

Confide test purchasers receive a pre-paid mailer for returning blood samples in addition to one-on-one counseling for two years.

Kari Petrocchi, an undeclared senior, said that the kit doesn't seem very reliable. If she did use it she would make sure to get a second opinion.

"It's interesting sending in your blood sample with a number attached to it," she said.

The company will offer a replacement kit if the blood sample is not readable or lost.

Cunningham said various reporters from Dallas and Texas have tried out the home test and the only problem one reporter had was the embarrassment of purchasing the kit. Now Confide has come up with a way around this problem.

"We created silent request forms that are located in the condom section," Cunningham said. "You hand the pharmacist the slip and they give you the kit without yelling out your name."

[ Golden Gater Online October 3, 1996 ]

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