Cape Town - It has been a raging debate for years: should South Africans have the option of conducting an HIV test in the privacy of their homes? While some have raised fears and ethical questions about it, others have argued that self-testing may have a positive impact on HIV-testing in a country with a low uptake of this critical test.
Last week, support for the self-tests received a boost as key HIV clinicians and ethicists threw their weight behind it.
Speaking at the SA Clinicians Society Conference held in Cape Town, Lucy Allais, a professor of philosophy, and director of Wits’ Centre for Ethics, said that as long as the tests were accurate, user-friendly and posed no harm to individuals, there should not be ethical concerns about its individual use. Instead of restrictions, Allais said the country should encourage the use of home-testing kits as many people dreaded having tests in clinics or hospitals.
It has been argued that testing would lead to early diagnosis and treatment.
“Evidence shows that men are less likely to use clinics to test for HIV, so having such home tests would benefit them. The reason for restricting such tests would be if they are to cause harm to individuals or are not accurate.
“I think it’s crucial that such testing should be linked to psychological services and treatment. But such counselling should not be imposed on people who don’t want to have it.”
Dr Krista Dong, director of iTeach (Integration of TB in Education and Care for HIV/Aids) in KwaZulu-Natal said self-testing would be useful in a province in which 60 percent of HIV-positive men had not initially tested for HIV.
In a study that her organisation did on self-testing, they found significant support for the concept, with even illiterate people able to test themselves accurately.
Out of 231 participants who used the kits, 99 percent obtained a valid self-test result, sensitivity of the tests were 97.4 percent and 98 percent of participants understood the next step of care such as going to the clinic for treatment if tested positive or do a follow-up test after three months if tested negative.
Dong said given the efficacy of such tests, there was no reason for them not to be used. But she admitted that the system was open to abuse, and partners could coerce their loved ones to have an HIV test against their will.
Brad Mears, the head of Atomo Diagnostics, which developed the AtomoRapid HIV test, said home-testing kits could tap into a market considered high risk – such as men sleeping with men and sex workers – who were often discriminated against in tests at clinics.
Cape Argus