Since you bring up the subject...
Time to Punt said:
Lots of opinions without a whole lot of facts here.
Sorry, but you don't know what you're talking about, with all due respect. Read on to see what I mean, and I truly don't intend to insult you. When I write scientific articles (my work), I have the habit of giving out references, but I don't feel like doing this here on MERB (my fun time), sorry about that.
Until someone has some data on whether inaccurate results are being obtained with this particular test I think assuming it gives significant numbers of bad results may be premature.
And assuming it gives reliable results is also premature, without seeing the studies! I am not commenting on HIV self administered tests in specific, but I am commenting on ALL self-administered tests, which are called in the medical/ scientific litterature "point of care testing", i.e. a test done at the bed-side (or home). There is
plenty of litterature on such tests giving much less accurate results (less sensitivity, more false negative results, etc) when done at the bedside by non laboratory personnel than done in a lab by well trained technicians. In the litterature, this is often related to as efficacy vs efficiency. The value of something done in perfectly controlled conditions (= best results) vs done "out there" in usual clinical conditions (= true applicable results). There is ample evidence of this in malaria, venous thrombosis, cardiac enzymes markers, and many other antigen based tests.
As far as self administered tests in general the perfect example of accurate reliable self administered tests is the blood sugar level testing done by millions of diabetic people every single day.
Well... actually there are some important considerations about this so-called "accurate" test! It is true that it is a common and easy test to perform. But... this test is different than an enzyme-linked latex agglutination antigen detection test (the HIV one). The glucose test requires measures quantitatively the sugar in a droplet of blood, but has a margin of error of +/- 1-2 mmol/L (the normal blood glucose range is 3-6 grossly speaking). So "precise" is not an accurate word. To be reliable, the machine has to be calibrated regularly. Diabetics who check their sugars daily will realize if their results are suddenly off by a lot and this will prompt them to seek out if there is a problem with either their health or their machine. This ensures some quality control into the process. A point of care testing, when done by a single individual, does NOT have this "alarm" mechanism-- i.e. the individual doing his own test will have no clue that the test is behaving strangely because you only do it once... Another fact is that an enyme linked test is a qualitative or semi-quantitative test. It answers YES or NO, but it usually has a threshold level of "something detected" to become "positive" or YES. For example urine pregnancy tests have a threshold of 50 IU of B-hcg (pregnancy hormone) needed to become positive. If you have 45 IU... you test "negative".
So, as much as you would like to say, one cannot compare self adminsitered HIV testing to home glucose monitoring for many... many reasons. It just does not make sense when you know about these tests.