On May 15, the Blood Products Advisory Committee of the Food and Drug Administration (FDA) will discuss whether to approve a take-home, oral HIV test that could revolutionize the way we think about testing. It has the potential to reach a far greater number of individuals who want to know their HIV status on their own terms.
This type of rapid, take-home test doesn’t come without debate between HIV testing counselors and those who support at-home testing. But in order to become the generation that ends HIV/AIDS, we must move forward and utilize new ways to empower people to know their status.
It's important to note that an over-the-counter, oral/rapid home test is not replacing the conventional way we currently test for HIV. It’s simply an additional resource, an additional option. I know from traveling and listening to feedback that many people, including some who have chosen not to know their status using conventional methods, find it intrusive to discuss their sexual history with complete strangers (as an HIV-positive individual for nine years, I know firsthand how difficult that can be). An OTC test puts the power in the hands of the person wanting to know their status to decide where they will do this, who they will tell, and how they tell it.
Everyone acknowledges challenges with this type of test — including the awful scenario of an individual committing suicide after finding out a positive result. No one wants to lose a life, but there are resources available to help reduce this risk. I have been very open with the manufacturer of this test, OraSure Technologies, as well as the FDA, about my concerns about counseling, linkage to care, and partner notification, to name a few. I know that many advocates believe that in-person counseling should be required for HIV testing.
But this mentality is the very reason why many individuals simply don’t get tested. Why limit our options if someone wants to know their status? There will be trained professionals available via phone, 24 hours a day, seven days a week. An individual never has to be identified if they choose not to be, but they will get the support and the linkage to care they need.
I have been following this project for seven years and have talked to thousands of people about this. As a result, I feel that now is the time to move forward with an OTC, rapid/oral test. If we want to become the generation that ends AIDS, we can't withhold the tools and technology from those who need them.
TOM DONOHUE is the founding director of Who’s Positive, a national organization that humanizes HIV through firsthand accounts of people living with the virus. He also sits on the board of trustees of the National Association of People With AIDS. www.tomdonohue.org