Home Access Health Corp., Hoffman Estates, Ill., markets the only home HIV test kit that has been approved by the FDA. The Home Access Express HIV test kit is as reliable as HIV tests administered by hospitals and clinicians, and is proven in clinical trials to be more than 99.9% accurate. 1

The Home Access Express HIV test kit provides everything needed to anonymously collect and ship a blood sample to Home Access's CLIA-approved laboratory.

Blood samples are taken via fingerstick, using a small, spring-loaded device provided in the kit. A few drops of blood are placed on a small, dime-sized blotter that is identified with a unique 14-digit code. Calling a toll-free number activates the anonymous 14-digit code. At that time, users can choose to speak to a counselor or use an automated registration and education system.

The blotter containing the blood sample is sent to the laboratory in a weather-resistant protective pouch that is placed in a prepaid Federal Express or U.S. Postal Service shipping envelope.

The test is completely anonymous, as only the test taker has access to his or her test results. There are no names associated with the personal Home Access Code number.

Throughout the testing process, professional counselors are available to provide assistance and answer questions. After results are received, anonymous post-test AIDS counseling and medical referrals are available if necessary.

Shipping and lab services are included in the kit's $59.95 price. Home Access Express HIV tests are available directly from Home Access on-line http://www.homeaccess.com or by phone [(800) HIV-TEST] and through nationwide retail pharmacies and drugstores.

Clinician's Critique

Home Access reports that more than 400,000 tests have been run since the FDA's approval in 1996. Home testing has yielded a positive rate of about 0.8%, compared to publicly funded clinics, which have a seropositive rate closer to 1.8%. Home Access reports a higher number of first-time HIV testers, as well as a larger number of persons who follow through and obtain the results of their tests (95%) than is typical for publicly funded clinics (67%).

There are both advantages and disadvantages to home testing for a potentially devastating diagnosis such as HIV. Home testing expands access to testing. Some individuals may consider this type of testing to be more acceptable, since it is anonymous, guaranteeing protection of privacy. Also, home testing is convenient. From a public health standpoint, it conserves limited public health resources.

It is unclear whether those with negative test results are more or less likely to change behavior as a result of counseling over the phone, as opposed to in person.

When conducting HIV testing away from health care settings, there is always concern about what will happen to the individual who receives an unanticipated positive result. Trained counselors give results of positive tests and work with the individual to refer him to clinics and social services. The company reports that there have been no suicides by persons who received their results in this way, although some persons hang up upon hearing the results without receiving counseling, and the fate of these individuals is unknown. Of concern are persons with psychiatric conditions, who might be less likely to have serious problems when counseled in a more controlled setting.

There is no guarantee that those who receive positive results will actually follow through and seek care for their HIV infection. At almost $60 per test, the cost is high, and therefore, is unlikely to be available to indigent populations.

Within the myriad of options for HIV testing, the home test has its place, although it is only one of several methods for an individual to be tested for HIV.

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