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libidoslave

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Self administrated test, i find this dangerous. Doing a diagnostic is a medical act and requires a profesionnal. I fear of peoples walking around saying "i'm clean" solely based on this, or on the other and, anxiety spread du to people misreading test....

And learning you are going to die sooner than you thought is a shock i would not like anybody to have alone without professionnals to guide you through proper ressources.


jimmy.the.great said:
http://www.homehivtestkit.org/home-hivtest-order.htm

this sounds cool , did any one tried this ?
 

Time to Punt

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Mar 25, 2009
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People used to say the same about home pregnancy tests. This is FDA approved so it should be fairly accurate. If it promotes more testing then I say great !

It is only for HIV though.
 

naughtylady

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Don't like it.

Go to a clinic and be tested for everything, not just HIV. If you are at risk for HIV you are at risk for many other things; some almost as nasty.

Ronnie,
Naughtylady
 

Tia Phoenixx

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libidoslave said:
Self administrated test, i find this dangerous. Doing a diagnostic is a medical act and requires a profesionnal. I fear of peoples walking around saying "i'm clean" solely based on this, or on the other and, anxiety spread du to people misreading test....

And learning you are going to die sooner than you thought is a shock i would not like anybody to have alone without professionnals to guide you through proper ressources.

you have your point my friend
 

hormone

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Feb 28, 2007
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libidoslave said:
Self administrated test, i find this dangerous. Doing a diagnostic is a medical act and requires a profesionnal. I fear of peoples walking around saying "i'm clean" solely based on this, or on the other and, anxiety spread du to people misreading test....

And learning you are going to die sooner than you thought is a shock i would not like anybody to have alone without professionnals to guide you through proper ressources.

This is true. Some years ago, the number one cause of death in HIV positive gay men in Montreal and all big cities was... suicide! Usually a short while after learning their positive test results.

The other thing is that there is a window of time after contracting HIV during which all the commercial tests will be negative and such a result may result in a lot of risky behaviour from the self-tester

People used to say the same about home pregnancy tests. This is FDA approved so it should be fairly accurate. If it promotes more testing then I say great !

FDA approval means nothing per se. Many studies about reliability of self-administered tests show high rates of false negatives (i.e. a test that seems to say "you don't have this" but the result is wrong, meaning you do have the thing). There are many reasons for this, the more common ones being performing the test adequately and incorrect interpretation of the result-- this is why they came out with pregnancy tests that give you the answer on a screen as YES or NO. Other reasons include manufacturing errors in certain test batch lots, tests past their shelf-life, lower sensitivity of the home test compared to the formal lab-machine test, etc...
 

Time to Punt

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hormone said:
FDA approval means nothing per se. Many studies about reliability of self-administered tests show high rates of false negatives (i.e. a test that seems to say "you don't have this" but the result is wrong, meaning you do have the thing). There are many reasons for this, the more common ones being performing the test adequately and incorrect interpretation of the result-- this is why they came out with pregnancy tests that give you the answer on a screen as YES or NO. Other reasons include manufacturing errors in certain test batch lots, tests past their shelf-life, lower sensitivity of the home test compared to the formal lab-machine test, etc...

Lots of opinions without a whole lot of facts here. 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.

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.
 

hormone

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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.
 
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Time to Punt

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Well you do seem to have strong opinions on the subject but I don't find myself convinced of their validity since I have not seen the write-ups on these many studies.

One small point to correct an inaccuracy though is that the blood sugar testing machines do not, in fact, have to be calibrated regularly and a movement in your reading from 6 to 14 is not unusual depending on the timing of the test and what has been recently consumed.

I am a borderline type 2 and have owned one of the hand held models for 3 years and the only adjustment required is ensuring the setting matches that of the batch of "sticks" you are using. Many newer machines and test strips now do not even require this.
 

hormone

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Time to Punt said:
Well you do seem to have strong opinions on the subject but I don't find myself convinced of their validity since I have not seen the write-ups on these many studies.

One small point to correct an inaccuracy though is that the blood sugar testing machines do not, in fact, have to be calibrated regularly and a movement in your reading from 6 to 14 is not unusual depending on the timing of the test and what has been recently consumed.

I am a borderline type 2 and have owned one of the hand held models for 3 years and the only adjustment required is ensuring the setting matches that of the batch of "sticks" you are using. Many newer machines and test strips now do not even require this.

My opinions are based on science, but as I mentionned, we are not at a scientific conference here. Up to you to believe or not. But if you have any doubt as to what I said, I do hope you have the same doubts about HIV self tests...

To clarify about blood sugar machines: they do not need to be calibrated to work, but you do need to calibrate them regularly (and it does not have to be every month in your case) to ensure the readings are correct (quality control). They will still work if you don't calibrate them... but you may never know they are off...

And as for the readings, what you say is true in a context akin to what you mention. But if you are a diabetic and have a strict diet and take your sugars regularly every day at the same time, after the same amount of exercise, your sugars usually do not vary from 6 to 14. Actually a reading of 14 is often the first clue for a well controlled diabetic person that "something" is wrong.
 

Time to Punt

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hormone said:
To clarify about blood sugar machines: they do not need to be calibrated to work, but you do need to calibrate them regularly (and it does not have to be every month in your case) to ensure the readings are correct (quality control). They will still work if you don't calibrate them... but you may never know they are off...

.

To re-clarify you do not have to regularly calibrate home glucose monitoring systems such as FreeStyle Freedom or OneTouch. If you have damaged ( dropping in water or on a hard surface for example) your machine or suspect you have purchased a bad batch of test strips they give to some synthetic "blood" to test. There is no way to re-calibrate it, you just throw it away.

You see here is where I get into problems. I was all ready to believe you about the HIV thing then you tell me something that is incorrect. I happen to know more about the glucose monitors simply because I'm an owner and a user. I even re-read the 39 page owner 's manual again looking for anything about required re-calibration. I then checked another competing system's online manual. Guess what ? No re-calibration is required beyond an initial test to see if it is functioning properly. When I gently correct you there is a come back insisting you are correct when you aren't. And in a lecturing tone no less :D

I'm hoping that you maybe your information/knowledge is just out of date and you were talking about the old-fashioned "clunker" hospital machines that are still widely used, but only in hospitals and old folks homes etc.

So now I can't just accept what you say and will have to read studies myself if I want to understand this further.
 
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Time to Punt

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WHO bulletin

While I have probably been extremely tiresome ( eh YVO ;) ) about critising WHO's woefully inadequate pandemic classification without severity system the article below gives whay appears to be a balanced discussion of the issues of HIV self-testing. Generally the author seems in favour of the tests for persons in developed countries but wants more study as to whether a person with positive results would disclose those results.


http://www.scielosp.org/scielo.php?pid=S0042-96862006001200017&script=sci_arttext
 
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