Last month, news broke that HIV home-testing kits were to be made available.
Last month, news broke that HIV home-testing kits were to be made available. Locally, a R22,5 million tender was approved for the kits, despite an international warning by the World Health Organization (WHO) that the kits were inaccurate. Later, Minister of Health Aaron Motsoaledi announced a government decision to recall 500 000 of the kits already distributed under the tender.
The Star reported that “the WHO did a laboratory assessment of two batches of the kits and found that 50 percent of them gave invalid readings”, which is why they never distributed them. According to Motsoaledi, the batch of test kits that South Africa received from a South Korean company were tested and concluded to be functional by the National Institute of Communicable Diseases (NICD). The Star goes on to say that “it was found that the two institutions (the WHO and NICD) were dealing with different batches from the same company.” The fact that the different batches are not equally accurate is an obvious cause for concern.
The tests work like the rapid tests conducted in clinics. You stick your finger with the lancet and allow one drop of blood to fall into the testing strip. You then add two drops of a developer solution which will detect the presence of HIV antibodies if you are infected. Alternatively, there are tests which use saliva from an oral swab instead of blood samples.
One of the major issues regarding the home-testing kits is whether or not a person will seek counselling if they test positive.
This is also a concern for professionals working in the HIV research field. Lerato Lebona works at the AIDS Research and Development Centre on campus. She explains, “The problem with HIV testing kits is that there is no pre-counselling to prepare you for whatever result you might receive and no psychological aid to help you deal with the news efficiently. We all react differently to news such as being diagnosed with HIV and there’s the possibility of an increased potential to commit suicide when one takes the test alone.”
Nadine Kumar*, a student at Tuks, has a similar point of view: “Some people don’t want counselling but if you’re tested positive, it’s within your best interests to have it because even though the likelihood is that you’ll be thinking ‘I’m gonna die’, the counsellors sort of give you a glimmer of hope that would be absent if you tested at home alone.”
Dimakatso Modigoe, a first-year student studying metallurgical engineering, has this concern about the kit. “I wouldn’t use it because I don’t trust it to be as accurate as tests taken in a clinic,” she says. “I also prefer the counselling service offered at a clinic because I believe the information I receive from there will be more practical and understandable than information on a pamphlet attached to the kit.”
Sister Bongi Mdletshe, who works at the Student Health Centre where free HIV testing is available for all students, says, “The home-testing kit and the testing we do here at the clinic are similar, but the home-testing kit provides you with only one testing strip,” she says. “When you’re tested at a clinic and the first result is positive, we perform another test using a different brand of testing strips and if that second test comes back positive, a blood sample is taken for lab testing as further confirmation of results.” She also mentions that there is an option to skip the pre-counselling, but post-counselling is given to those who test positive. “The average number of students who test for HIV here is 2 000 per year and that is far below the number we’d like to achieve seeing as there are more than 55 000 students on campus,” she says.
Tuks student Amogelang Tshabalala* says, “Buying a home-testing kit is like buying condoms. You don’t want people to see you buying things related to sex.” Conversely, there are many students like Tshabalala who do not wish to have counselling. So the kit could eliminate a factor that discourages a certain part of the population from getting tested.
Perdeby surveyed one hundred students on campus on whether they’d opt for HIV home-testing kits or use the conventional way of going to the clinic, and the response was precisely 50-50.
While there are many obstacles facing the HIV home-testing kit, what is certain is that this is a technological leap which, if correctly handled, could change HIV testing for the better.
* Name has been changed.