World AIDS Day is approaching on December 1. As I was looking up more about World AIDS Day and awareness and testing guidelines/suggestions, I discovered there are several other similar days for awareness including National HIV Testing Day (NHTD), June 27, an annual observance to promote HIV testing. There are also days set aside for women and girls and for various cultural and race subsets.
I was unaware that over the counter testing kits for HIV were available in the US already (though the FDA approved their manufacture in July 2012) until I watched this video. Take a look.
The video wonders if there should be a broadening of whom should be tested on a regular basis? I wondered if the availability of an OTC test would have a significant public health impact.
This is not my area of expertise so I asked public health expert, Philip Alcabes, an epidemiologist and writer, to be so kind to offer his insights. Philip Alcabes studies the history, ethics, and policy of public health. In addition to his book Dread: How Fear and Fantasy Have Fueled Epidemics from the Black Death to Avian Flu (2009), he has written essays on these topics for The American Scholar, Virginia Quarterly Review, and the Chronicle of Higher Education, as well as peer-reviewed journals. In the 1980s and ’90s, he conducted epidemiologic research on AIDS and other community-acquired infections, social issues in the spread of epidemics, and methods for the statistical study of infectious diseases.
"I don't see any harm in OTC HIV testing. For people who want to spend the money to have a moderately reliable result reassuring themselves that they're not harboring HIV, they will have a way to do so. It will make plenty of money for the test manufacturer, since many people are likely to want such reassurance. Perhaps one or two people who are infected with HIV will discover that sooner than they would have otherwise, and get themselves into treatment. But it's not going to have any public health impact. A thousand adults would have to do OTC HIV testing in order to uncover a single previously unrecognized HIV infection. And almost all of those infections that are uncovered by OTC testing would have been detected eventually. Meanwhile, people who want to protect themselves against the slight possibility that a sexual partner carries HIV can do so using readily available and inexpensive means, i.e., condoms. In fact, the biggest worry would be that OTC HIV testing might be so popular that it would entice people to drive to their pharmacy -- since about three times as many Americans die in vehicle accidents nowadays as die of HIV. In summary, I see no impact of OTC testing on the profile of HIV in the US. It's certainly not a game changer. And, please drive carefully."
If you are interested in epidemics and would like to hear more from Dr. Alcabes, here is my review of his book from 2009 at the height of the Avian Flu scare.