Internationally, almost 60% of the Human Immunodeficiency Virus (HIV) infected people have not been tested. Such people are not aware of their serostatus (Krause et al. 735). In different parts of the world, access to testing is still an issue, and fear of discrimination and stigmatization are a threat to HIV testing services’ acceptance. In America, some people with HIV are undiagnosed, and such people can be responsible for about one-half of HIV/AIDs transmissions in the nation (Wood, Ballenger, & Stekler 117). Consequently, routine and repeated HIV testing or screening are highly recommended for patients in health care centers. Accurately, HIV screening methods are essential since they increase the rates of diagnosis; this can create room for early antiretroviral therapy for the infected individuals’ health and decrease the possibilities of transmissions to susceptible individuals (Wood, Ballenger, & Stekler 117). Nevertheless, this paper will pay much attention to the argument for self HIV testing, though it will highlight some arguments against the testing.
Self-testing is a familiar concept; it has been essential in diagnosing and managing different health conditions, for instance, diabetes, colon cancer, and pregnancy. HIV self-testing involves the collection of a finger stick blood or saliva sample for analysis by the user. Generally, people complete this kind of testing with no or little training (Wood, Ballenger, & Stekler 118). If the testing is unsupervised, cautions and instructions are always provided. From the time it was introduced, HIV self-testing is always subjected to scrutiny by researchers, regulatory agencies, as well as users because of potential social, ethical, and legal issues (Rapid Response Service 1). Nevertheless, some people support it while others are against it.
The argument for HIV Self Test
Among the things that ought to be considered in relation to the HIV self-test are accuracy, acceptability, destigmatization, and empowerment. The rapid HIV self-test is accepted by individuals who are at the highest risk for HIV infections. Moreover, the results of self-tests are trusted and highly accurate.
In relation to the acceptability of HIV self-testing, home self-testing is highly accepted and recommended since it associated with minimal supervision (Wood, Ballenger, & Stekler 119). The fact that it is not associated with no false-positive results and false-negative results being rare, people consider HIV self-test to be more accurate. The test has also attracted individuals who have never been involved in HIV testing by other means or do not know their serostatus. Among the things that should be considered corresponding to the HIV individual test are exactness, worthiness, destigmatization, and strengthening. The quick HIV individual test is acknowledged by people who are at the most elevated danger for HIV diseases. Additionally, the consequences of individual tests are trusted and profoundly exact.
Comparable to the adequacy of HIV self-testing, home self-testing is exceptionally acknowledged and suggested since it related with negligible management (Wood, Ballenger, & Stekler 119). The way that it isn’t related with no bogus positive outcomes and bogus antagonistic outcomes being uncommon, individuals believe HIV individual test to be more exact. The test has additionally drawn in people who have never been engaged with HIV testing by different methods or don’t have the foggiest idea about their serostatus.
Apart from accuracy and high acceptability, HIV self-testing is recommended because of the empowerment of people (Wood, Ballenger, & Stekler 118). It also reduces stigmatization, in addition to having the ability to test in a private, anonymous, and confidential manner. Discrimination and stigma, in health care settings, are huge barriers to HIV testing because of fear of the patient’s confidentiality being breached and long waiting time to get the result. Self-testing is assumed to be private and highly confidential and participants, who use self-test kits, believe that it can give them, over their health, more power.
Another reason HIV self-testing is highly recommended is that it increases awareness of risks, promotes testing and disclosure, in addition to improving the serosorting’s accuracy (Wood et al. 120). Since self-testing kits are accessible, people’s attitudes and behaviors have changed; this incorporates being aware of the risks, in addition to more discussions of safe-sex practices. Moreover, in instances where a partner tested positive, sexual encounters stopped (Carballo-Die´guez, Frasca, Balan, Ibitoye & Dolezal 1753). This is also the same case for the partners who are not willing to test themselves. In other words, after a positive test, people prefer not to have sexual intercourse, and this suggests that the HIV self-test can cause increased awareness of the possible risks, in addition to averting sex between discordant partners.
The argument against HIV-Self Test
Though there is, around the world, increased availability of HIV self-testing, there are concerns about lack of test counseling and the need for the individuals who have tested positive to be linked to appropriate care. Another issue arising with this is the fact that there are moments confirmatory testing is essential.
In some regions, for instance, New York, where it has been legalized, self HIV-testing remains to be a concern (Wood, Bellenger, & Stekler 121). In pharmacies, there is a possibility that self-test kits are always placed behind the counter. As a result, in high-morbidity areas, interaction with the pharmacy staff is a must. Some pharmacies still sell the kits at prices above the suggested retail price of the manufacturer. So beyond cost and legality, awareness of the self-test kits, together with the access to these kits, remains to be obstacles.
Another significant concern is associated with HIV self-test is false-negative results (Wood, Ballenger, & Stekler 121). Also, in the window period, the missing infection can be experienced; this is because the early diseases are known for sometimes exhibiting high viral loads, as well as high transmissibility. If people with high and frequent HIV risk behaviors access the self-test, during the window period, a negative test can lead to false reassurance; hence, increasing sexual intercourse (without condom) with the HIV-negative partners. Hence, HIV transmission will be propagated.
Since missed early infections can be experienced, materials accompanying self-test kits can be stressful to the users. The false-negative results’ risk and acute-retroviral syndrome’s signs during the window period has made care providers not to consider replacing the clinical-based testing with self-test. Self-test ought to be a supplement for patients who cannot do screening in health care centers (Paltiel & Walensky 745). If a self-test is used as a supplement screening, the prevalence of HIV is likely to decrease. Moreover, the positive results ought to be confirmed and the adverse effects to be repeated by more sensitive tests.
Unsupervised HIV self-testing is associated with a lack of in-person or formal counseling (Wood, Ballenger, & Stekler 122). Wood, Ballenger and Stekler believed that some countries do not recommend the use of self-testing because false-negative tests can cause false reassurance. Without in-person counseling, patients will not have the opportunity to discuss the possible risk of prevention with their health care providers. Moreover, the patient will not be in a position to ask sufficient questions. With the HIV self-testing, there are phone counseling services, though they can never be as effective as face-to-face counseling.
In isolation, there is a concern regarding an individual’s psychological reactions when the patent gets a positive result (Wood, Ballenger, & Stekler 122). After positive tests, suicidal thinking has become less frequent with the effectiveness and availability of antiretroviral therapy. Nevertheless, in settings with limited resources, suicidal thinking is likely to occur.
Apart from limited counseling, another disadvantage of HIV self-testing is how the patient can be linked to care (Wood, Ballenger, & Stekler 122). Individuals who consider self-test because of fear of discrimination or stigma are at a greater risk of avoiding presenting or linking to healthcare for the same reasons. After testing positive, the patients can consider not to call for support.
Further disadvantages to HIV self-testing are associated with resource-limited settings, for instance, issues related to regulations of test developments and sales, storage of tests and self-tests’ quality control. The self-tests also heighten barriers to HIV-related counseling and linkage to patient care that is given to isolation and geographical distances. Moreover, since rapid tests are antibody-based, HIV self-testing has limited utility for infants’ HIV screening (Wood, Ballenger, & Stekler 123).
HIV self-tests have managed to reach the highest-risk people who have never been screened for HIV. The self-test promotes mutual partner testing and, therefore, averting sex without using condoms between discordant partners. It is also through HIV self-test that stigmatization can be potentially decreased, in addition to assisting in normalizing testing. Nevertheless, several concerns still persist, i.e., access and cost, false reassurance, linkage to care, coercion, limited counseling. Also, during the window period, missed early infections can be experienced.
Proper regulatory, community involvement, legal framework, and correct information can assist in reducing the risks associated with HIV self-test. In spite of the potential social risks, the self-test has made it possible for more individuals to know their status and empower them to consider taking care of their health. As people get to know their HIV status, there will be a demand for effective treatment. Health care systems will also be strengthening to support patients that have tested positive.