Home HIV testing gets the green light

Home HIV testing gets the green light. After years of debate about the merits of home HIV testing, a ban has been lifted on pharmacist sales of do-it-yourself HIV tests.

harmacists can sell take-home HIV testing kits, according to Pharmacy Council of South Africa Registrar and CEO Amos Masango.

According to Masango, a May 2015 decision by the council effectively quietly removed the ban on pharmacist sales of HIV self-testing kits. The decision comes almost one year after the council gazetted a draft plan to remove the ban. The proposed lifting of the ban was warmly received publicly, according to Masango.

Over a year of deliberations

"Most pharmacists and the public felt that a pharmacist was better placed to deal with the sale of such tests given the sensitivity and the professionalism required in dealing with the condition," said Masango, who explained that after more than a year of deliberation, the council has now green-lighted the sale of do-it-yourself tests.

"The council in October 2014 had decided not to publish the minimum standard for implementation until such time that a standard for selling of HIV tests kits had been designed," he added. "In May 2015, the council finally resolved that the minimum standards – which effectively removed the ban for pharmacists to sell the HIV test kits that were approved in October 2014 – were sufficient and that there was no requirement to formulate further standards for selling HIV test kits.

"Pharmacists are in a position to sell these kits at this point in time," said Masango, who added the council would now be looking to release a set of minimum standards to assure the quality of HIV self-tests.

Tests get support

The Southern African HIV Clinicians Society has previously voiced its support for home testing although president Francesca Conradie has said that guaranteeing test quality will be important.

According to Southern African HIV Clinicians Society President Francesca Conradie, assuring the quality of testing will be crucial.

"There are many people who want to test and who do not want to interface with the healthcare system. We believe the more people testing, the better," Conradie said. "Let's get as many people to test as possible."

In 2010, the South African Medical Association issued statement warning that self-testing in the absence of trained counselors could be risky for newly diagnosed people living with HIV.

"Whilst rapid testing may assist in facilitating the diagnosis of HIV infection…tests have important implications for the individual, especially in respect of HIV counseling," said the association in the statement.  "There is also the danger of people committing suicide after being informed of their HIV-positive status, or even following misinterpretation of the results of the home test kit."

Concerns remain

Lehlohonolo Adams Clinic counsellor Lydia Lesala said she shares the association's previously state concerns.

"Anything can happen if you test yourself," said the counselor from Douglas in the Northern Cape.  "You might accuse people wrongly of infecting you and some people can even commit suicide".

Lesala also had concerns about whether people who tested HIV positive at home would report to their local clinics for crucial tests needed to determine whether they should start HIV treatment. Pharmacist Rachel Strydom said pharmacists might need to provide pre-test counseling when they sell the take home tests.

But some like Douglas resident Maria de Vos said that finding out your test results in your home has its advantages.

In the comfort of your home

"You always hear on the streets about those private conversations between patients and counselors," she said. "I'd rather find out in the privacy of my home, and not have everyone on the streets know my business."

Conradie also cautioned that concerns about what people may do if diagnosed in the privacy of their homes might be exaggerated.

"People do home testing for a variety of other things such as pregnancy and drug tests," she said. "We feel the notion that people will (engage in) self-harm if they find out alone that they are HIV positive is a bit paternalistic.

HIV self-tests are already available in some pharmacies for about R35. – Health-e News.