The US food and drug administration has approved an over-the-counter test for HIV. You can buy it in a drugstore, take it home, swab your cheek, and know if you’re HIV positive in the next 40 minutes. Sounds revolutionary, right?
Not so much. The challenge of HIV testing has never really been access, at least not in the sense that a home test kit would help.
Globally, the challenge has been convincing people they want to be tested. Most of the time, people who don’t know their status either know they’re at risk and don’t want to test or have no idea they could get HIV and might need testing. Being able to buy a test and use it at home doesn’t solve either of those problems.
There is a small subset of stigmatized populations all over the world who may want testing and be afraid to go to a health care center for fear of mistreatment. For example, undocumented immigrants, sex workers, or racial or ethnic minorities. Being able to buy a test anonymously and test at home would improve access for them. These groups, however, are also least likely to be able to afford a costly home test kit.
In the developing world, there is an access issue, but it centers on cost and training. There isn’t enough money to pay for HIV testing, and there aren’t enough providers trained in counseling people who take the test. The new home test kit doesn’t solve the cost problem. It isn’t cheaper than the kits used by clinics. In fact, it is expected to cost per kit more for over the counter purchase than health care providers pay for professional testing supplies. It doesn’t help all that much with the provider gap, either. Every positive result will require a second test to check for false positives, and a health care provider who can counsel the patient.
The home test kit for HIV will help some people. Every tiny step forward in increasing access helps. BUT it’s not a global health breakthrough – not at this price point.