FDA Approves HIV Home-Use Test Kit 186
Hugh Pickens writes "The LA Times reports that the Food and Drug Administration has approved the first over-the-counter HIV test kit, allowing people to test themselves in private at home and get preliminary results in less than 30 minutes. The test, which works by detecting antibodies in a swab from the gums, should not be considered final — in trials, the test failed to detect HIV in 1 in every 12 patients known to be infected, and returned false positives in 1 in 5,000 cases. The new at-home test, called OraQuick, will be sold in supermarkets and pharmacies and manufacturer, OraSure, has not said how much the test will cost, only that it will be more than the $18 cost for the professional kit. The federal Centers for Disease Control and Prevention estimates that of the 1.2 million people in the U.S. with HIV, 1 in 5 is not aware of the infection and that a disproportionate number of the 50,000 new cases of HIV each year is linked to people who have not been tested. Chip Lewis, a spokesman for Whitman-Walker Health, which provides AIDS care in Washington, says at-home testing could reach some people who didn't want to go to a clinic but removing medical professionals from the process could cause problems. 'It's not like a home pregnancy test,' says Lewis. 'You need really a lot of information about how to read the test, how to use the test properly.'" Back in May, we reported that a panel of FDA experts recommended approval of an over-the-counter HIV test.
Use it on someone else? (Score:5, Interesting)
Nobody seems to have noticed the "best" thing about this test: it should be possible to use it on your partner. With or without their consent. So you can invite that random girl at the bar home for a drink and a swab, or secretly swab your boyfriend while he's sleeping, just in case he's lying to you about being clean.
Unethical? Yes. Unromantic? Yes. False sense of security? Yup. But potentially lifesaving? Also yes.
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Not really clever at all. You'd better use condom, which is 99% safe if you use it properly (test fail in identifying 1 in 12 individuos)
After all, taking body fluids from someone without his/her consentiment is illegal.
Re:Use it on someone else? (Score:5, Insightful)
Nobody seems to have noticed the "best" thing about this test: it should be possible to use it on your partner. With or without their consent. So you can invite that random girl at the bar home for a drink and a swab, or secretly swab your boyfriend while he's sleeping, just in case he's lying to you about being clean.
Unethical? Yes. Unromantic? Yes. False sense of security? Yup. But potentially lifesaving? Also yes.
If you distrust this partner so much that you're willing to give them an HIV test without their consent, do you really want to bet your life on the 1 in 12 chance that the test will give a false negative result?
Besides, there are lots of other diseases you can pick up from this partner even if he/she is not infected with HIV. Better to be safe than sorry.
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AIDS is the only currently incurable life threatening disease you can get that I know of. You may get herpes, which is incurable .. but its not usually life threatening. You may get hepatitis C, which is life threatening but the cure rate is fairly high (and improving) with modern treatment regimens.
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AIDS is the only currently incurable life threatening disease you can get that I know of.
You have cures for Hepatitis, Creutzfeldt-Jakob, Alzheimer's, Leukaemia, Parkinson's, Huntington's, Polio, Lupus and Diabetes?
And influenza too - even though the fatality rate is low, the infection rate is so high that it kills an awful lot of people every year.
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I'm pretty sure he was talking about sexually transmitted diseases... Therefore, apart from Hepatitis, which have vaccines and and some very effective treatments, all the other one's become irrelevant in this discussion...
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Might not stay that way thought. I heard on the radio there is an extremely antibiotic resistant clap from Japan making its way to the west coast.
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Although the chance of a false negative may be 1 in 12, the actual probability of getting AIDS is less .. because you have to account for the probability of encountering an HIV positive person. Also, many false negatives are for cases where the person may have been recently infected so the immune system has not created enough antibodies. If you have been dating your partner for a while and can be sure he/she hasn't had an HIV exposure within a recent time frame .. the chance of false negative reduces. What
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Although the chance of a false negative may be 1 in 12, the actual probability of getting AIDS is less .. because you have to account for the probability of encountering an HIV positive person. Also, many false negatives are for cases where the person may have been recently infected so the immune system has not created enough antibodies. If you have been dating your partner for a while and can be sure he/she hasn't had an HIV exposure within a recent time frame .. the chance of false negative reduces. What this test allows you to do is have an added layer of security. It's like this, when you get in a car .. you can reduce your chance of getting seriously hurt in an accident by being a good driver, driving a safe vehicle, and wearing a seatbelt. Does it offer a guarantee of safety? No. I'm pretty sure people have died with their seatbelt on, in fact i recall hearing that some side impact collisions resulted in fatalities BECAUSE the person was wearing a seatbelt. However, seatbelts have saved many lives, so it's a good idea to use one. It reduces the probability of serious injury. That's what this test is about .. it's helping people who can't help but engage in a particular behavior pattern reduce the risk from that behavior -- yes for maximum benefit it must be coupled with other things like not choosing a high risk partner etc. But simply telling people to just plain abstain has not worked for everyone. So in combination with all the other things such as abstinence education, this test is a good thing.
Note, I am not in blanket favor of testing someone for HIV or anything else without their consent.
Or does it act like a false layer of security like an airbag. Drivers may think "Oh hey, I don't need a seatbelt, I have an airbag!" even though the seatbelt is what keeps them in place so the airbag is most effective.
Likewise, is someone who is in a high-risk group for HIV going to take this test, come up with a negative result, and then go out and tell his partners "Don't worry dude, I'm clean, I was tested". While if he'd had a test at a clinic (even if they use the same test), they would have explained
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Yes it is possible to come up with scenarios where this test results in infection. But how common is that scenario going to be? Overall this test may save lives.
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I remember a time when condoms were considered absolutely unromantic.
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Steps
1) Get partner home from bar
2) Get them to sleep as soon as they reach your home
3) Test them for HIV
4) If they test negative, wake them up and have sex.
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1) Slip some GHB into your partners drink at the bar.
2) Take them home
3) Test for HIV while they are still unconscious
4) If they test negative, rape
5) spend 10 years hiding in embassies (Score:2)
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What i like about this is the possibility of social pressure :-)
and being "at home" possibly some who would never get tested will take one (for curiousity or due to this pressure) and if that catches a few positives (even a few false positives) that go get checked up at the doctor, that should be an overall win to society.
Good and bad (Score:3)
This seems like a really good idea in that a lot of people who really should get tested never will due to the stigma of going to a clinic.
You need really a lot of information about how to read the test, how to use the test properly.
That would to me seem the least of the problem. The whole finding out you (might) have a terminal illness while alone in your bathroom might cause some issues. I know I'd probably be a tad upset.
Re:Good and bad (Score:5, Insightful)
This seems like a really good idea in that a lot of people who really should get tested never will due to the stigma of going to a clinic.
On the other hand, it seems like now 1 in 12 will never go to a clinic because the home test gave them a clean bill of health when really, they were carrying the virus. I understand that a false positive is going to be hugely upsetting to the individual, but on a society-wide level, such a massive false negative rate is really much more concerning. In my opinion, it makes the test not only useless (as a high false-positive rate would) but counter-productive.
Re:Good and bad (Score:4, Insightful)
This seems like a really good idea in that a lot of people who really should get tested never will due to the stigma of going to a clinic.
On the other hand, it seems like now 1 in 12 will never go to a clinic because the home test gave them a clean bill of health when really, they were carrying the virus. I understand that a false positive is going to be hugely upsetting to the individual, but on a society-wide level, such a massive false negative rate is really much more concerning. In my opinion, it makes the test not only useless (as a high false-positive rate would) but counter-productive.
And it's not just the fact that they won't go to a clinic for themselves, but now those 1 in 12 will proclaim to future partners "Don't worry, I'm clean, I was just tested". And if there's a biological reason that makes an individual more likely to get a false negative, this makes the problem even worse as he continues to get negative results, test after test despite being infected.
I'd feel better about this test if the false positive and false negative rates were reversed. Sending 1 out of 12 people to the doctor because they got a false positive (and missing just 1 out of 5000 actual HIV infections) sounds a lot better than the reverse.
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this makes the problem even worse as he continues to get negative results, test after test despite being infected.
Is this the case ? Or only the 1st time right after contamination when the body hasn't produced enough antibodies yet ? Can someone be (1) a carrier and (2) a spreader while (3) having no antibodies ?
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This is a general screening test intended to be used by the population at large, rather than a diagnostic test. As-is, it's got good positive predictive value [wikipedia.org] and a reasonable negative predictive value [wikipedia.org]: if given to the entire US population (minus tho
Re:Good and bad (Score:4, Insightful)
I don't get it. Yours is the third or fourth comment I've seen lamenting the failure rate. If you are sexually active, with multiple partners, you should be getting tested every 6 months minimum. With an over-the-counter version for about $20, I'm probably going to do it every month. (I'm a bit of a hypochondriac, but I do get laid occasionally.) I like to think of myself as unusually unlucky, but 6 times in a row? That is rather improbable.
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> That would to me seem the least of the problem. The whole
> finding out you (might) have a terminal illness while alone in
> your bathroom might cause some issues. I know I'd probably be
> a tad upset.
except you probably shouldn't be. The number of people without HIV dwarfs the population with it enough that there are many many more false positives than true positives, even with a very low false positive rate.
So even if you test positive, you are actually far more likely to be one of the people w
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It's no longer terminal with today's antiviral drug regimens. However, it is still incurable, and if you have HIV you'll need to take a very large cocktail of some very dangerous drugs for the rest of your life.
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Haha, no it's not a badge of honor in the gay community. There's a huge stigma that actually keeps people from getting tested.
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I doubt living with a ticking time bomb is that much of an honor. Survival rates are up but not everyone does as well as Magic Johnson.
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In fact in the gay community it's almost a badge of honor.
Citation fucking needed. And no, "my pastor told me" isn't going to cut it, nor will citing websites with an obvious religious or homophobic agenda. Nor will anecdotal evidence, as my anecdotal evidence is just as valid as your (i.e. not) and a 180 opposite from what you're claiming.
Maybe, just maybe, there's a gay subculture I've never seen that treats an aids diagnosis as a badge of honour. Or more likely there's a meme that such a subculture exists, and that meme is transmitted among the portion of th
Re:Good and bad (Score:4, Funny)
Maybe he got it from the toilet seat?
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It is possible, although extremely unlikely to get the HIV virus from fly bites (but not from mosquitoes). Plus some people who got infected through blood transfusions before testing became ubiquitous, and who have not developed AIDS.
Not enough so that one should be concerned about it, but still one should not jump to the conclusion that HIV positive means someone has had unprotected sex or shared needles.
Also, you may get false positives from people with type1 diabetes or certain auto-immune diseases.
So d
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People with HIV are living old now and dying of other causes
They've always died of other causes. AIDS in itself isn't fatal, but you easily contract other conditions that will kill you.
Much like many auto-immune diseases, it's not the disease itself that will kill you. But it is a (or the) significant factor.
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I'm pretty sure the GP meant "dying of other causes unrelated to AIDS." E.g., accident, heart disease, stroke, etc.
Pneumonia is one of the notable causes of death for people with AIDS. You don't have to have AIDS to get that. It's just way more lethal when your immune system is out of whack.
Another is suicide.
This will end badly... (Score:3, Insightful)
Re:This will end badly... (Score:5, Insightful)
People (as a group), who have proven themselves to be not the best logicians time and time again, will take this as proof they are in the clear and start spreading it around.
People who feel they need to use this test are already spreading it around. If this stops 11 of 12, that is a good thing. Just because something isn't perfect, doesn't make it worthless. Life is not black and white.
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You are making a big assumption this will stop them. Lost of people go around having unprotected sex with multiple partners. They should therefore get tested for a variety of STDs regularly so as not to put others at risk but they don't.
These are people to embarrassed to ask a medical professional for an HIV test or to narcissistic to bother. Do you really think they are going to either start telling partners, sorry I am HIV positive we should use protection, or change their life style for more than a fe
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Uh nobody was bribed, I am sure the packaging will explain the failure rate. This will save more lives than those it may result in infections with. It is a safeguard for people who might otherwise engage in risky sex. It's like using a condom. Condoms are not 100% either. The 1 in 12 failure rate is because new/recent infections wont show up. So if you are really paranoid about htat you can wait for a 6 months period. Also, the 1 in 12 failure is not that high in the context of the probability of encounteri
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If the target market has a low enough prevalence of HIV, a high false negative rate is fine. Almost every test has false positives and false negatives, but the importance of that depends on the rate of true positives in the population.
In general, for low risk groups we want to minimise false positives more, and for high risk groups we want to minimise false negatives more (assuming in both cases that the true positive and true negative rates is high enough to be useful).
Therefore, this is a useful test in p
Error Rate High, but Still Useful (Score:1)
Yeah, the error rate is very high, but consider that this test might catch a large fraction of folks who might never get tested. That's a net win.
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Yeah, the error rate is very high, but consider that this test might catch a large fraction of folks who might never get tested. That's a net win.
Not if it leads to Typhoid Marys who go on infecting a large number of people because tested negative!
good thing for the affordable care act or this wh (Score:2)
good thing for the affordable care act or this would of been a easy new way to get on the blacklist aka the per-existing conditions list.
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Anonymous HIV testing has long been available in the US. And approving OraQuick for OTC sale will make it even easier to be tested without your health insurer, or anyone else, knowing. But yes, in a single-payer system, we wouldn't have to be so guarded about pre-existing conditions, and one would be able to get the treatment(s) they need for preventing and transmitting disease without having to wonder if they could be blacklisted.
They should sell these (Score:3, Interesting)
in night club/bar bathrooms.
It's 1:40 and you've hooked up with your last resort, you go back to your place but before you put yourselves at risk, take 5 minutes and show each other that you don't have HIV.
I say this is all around win!
LK
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That is the most awesome idea ever.
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And then you take her home and catch incurable gonorrhea [go.com].
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Or just wear a condom. Duh.
Republican policies at work (Score:4, Insightful)
We can see it in the massive farce that is "abstinence only" education, turns out kids are having sex anyway and since they cannot get, or do not have access to condoms(and have been told that they fail most of the time anyway) they are going about it without them. Results? Highest STDs and teen pregnancy rates in the rich world.
And lets not forget our hardon for "justice" that results in a massive # of people(mostly men) in prison at any given time, where, surprise surprise, HIV runs rampant. And perhaps related refusal to admit that people are going to shoot up, and if they do they should have clean needles ends up in a lot of drug users contracting HIV(a very large % of those infected with HIV in the US are also infected with hep-C, indicating that needle-born HIV infections in the US are much more common than other first-world countries)
And of course lets not forget the massive amount of homophobia that basically ensures a large # of homosexuals will be ostracized from their family and community, and thus have a very low level of self-worth. This translates into many gays engaging in self-destructive behavior in the US, including but not limited to risky sex.
Congrats Republicans, largets HIV infection in the rich world, you worked hard to get to this point, might as well celebrate.
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Yes! Never mind that these are all features of the American psyche built over centuries. It is those darn Republicans.
Never mind that both Republican and Democrats want the government in our (quasi-mandatory public) schools which is specifically what enables "abstinence only" policies to be put into place by Republicans. It's Republicans all the way down!
Never mind that the Democrats are just as hard on drug users and sellers as the Republicans. It's those darn Republicans at it again!
Never mind that gays m
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Posting anon since there is still a huge stigma with being HIV positive...
I am HIV positive. I am a registered Republican. And I am an atheist.
Not all Republicans are religious nutjobs in the same way that not all Democrats are hippie nutjobs.
I am getting sick and tired of the "my team = good, your team = bad" divisiveness which is tearing this country apart. We can't even have intelligent debates on ideas anymore if one person discovers the other is a "libtard" or a "teabagger".
The above post contains assu
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I am HIV positive. I am a registered Republican. And I am an atheist.
Not all Republicans are religious nutjobs in the same way that not all Democrats are hippie nutjobs.
I guess not. Apparently some of them are dumb enough to vote for a party who isn't even interested in making good policy to slow the spread of a terminal disease you suffer from, and whose leaders barely even consider you a citizen. In short, you're even dumber than the average republican.
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I am HIV positive. I am a registered Republican. And I am an atheist.
Not all Republicans are religious nutjobs in the same way that not all Democrats are hippie nutjobs.
So you're either delusional and think Goldwater and his ilk are still in charge of the Republican Party, you're delusional and think you're going to change the party from within and wrest control back from the religious nuts, you're wealthy and look to benefit from the tax policies the Republicans endorse, or you're delusional and think that IT (The Dream Job, The Lottery Win, The Inheritance, etc.) will happen to you and you'll then benefit from the aforementioned tax policies.
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Why the huge disparity? Probably has something to do with the fact that in the US there are a large # of people who secretly want "sinners" to get infected as punishment for their "deviancy", we call these people Republicans.
As much as I dislike Newt, Rush, and Mitt, I just don't see any evidence of that. More liikely, the reason we have so much more AIDS is that poor prople simply don't go to the doctor; they can't afford it. They go to the ER when they're at death's door, and by then have likely infected
Sensitivity is only part of the story (Score:4, Interesting)
To review, sensitivity is the probability of a positive result given that the tested individual is actually positive; specificity is the probability of a negative result given that the tested individual is actually negative. The OraQuick swab test has a rather low sensitivity, meaning that there is a roughly 1 in 12 chance that an HIV-positive individual incorrectly tests negative (type II error). But it has a relatively good specificity, meaning that there is a roughly 1 in 5000 chance that an HIV-negative individual incorrectly tests positive (type I error).
The value in granting FDA approval for OTC sales of OraQuick, then, is to address the need for the vast majority of the population, which is HIV-negative, to feel reassured that they are in fact negative. Historically, one of the biggest challenges in HIV education has been overcoming the fear and stigma of testing. Making testing available OTC greatly improves the likelihood of getting regularly tested.
But what of those pesky type II errors? Yes, given that an individual is actually HIV-positive, the chance that the test fails to detect is is 1 in 12. But that is NOT the same thing as saying that given a negative test result, the chance the person is actually HIV-positive is 1 in 12. For the general population, that probability is much smaller. In fact, I leave it as an exercise for the reader to calculate the negative predictive value (which would require the prevalence of HIV in the US population). Now, if we were talking about using OraQuick on a very high-risk group, we would expect many more false negatives, so a more appropriate test would be the standard ELISA blood test, followed by a confirmatory Western Blot. But remember, FDA approval of OTC OraQuick is targeted at the general population. If you know you're in a high-risk group, you presumably would be getting regularly tested at a public health clinic, and OraQuick isn't necessarily your best choice. But it's still better than not getting tested at all.
Finally, remember that any reasonable person who tests positive with OraQuick would want a follow-up test to be sure. (Someone who tests negative, however, is much more unlikely to want a follow-up test.) So we don't really need to worry about type I errors, except for the panic and anxiety such a rare outcome might cause.
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If you know you're in a high-risk group, you presumably would be getting regularly tested at a public health clinic, and OraQuick isn't necessarily your best choice.
If you know you're in a high-risk group, you're probably not making the best decisions anyway. In fact, you're probably looking for an excuse to continue your destructive behavior. Why would such a person go to a clinic instead of popping one of these in their mouth just before hooking up with a new partner?
Re: Sensitivity is only part of the story (Score:3)
From Wikipedia, the background rate of HIV in the USA is 0.375%: 1,200,000 people are HIV+ and 310,800,000 are HIV-.
From the sensitivity: of those 1,200,000 who are HIV+, 100,000 (1 in 12) would test -ve, and 1,100,000 will test +ve. And from the specificity: of the 310,800,000 who are HIV-, 310,737,840 would test -ve, and 62,160 (1 in 5000) would test +ve.
This means that of those 310,837,840 who test +ve, 94.7% would actually be HIV+. And of those 1,162,160 who test -ve, 99.97% wou
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If you remove the people who are HIV-positive and know it from the groups, the numbers shift: of the 240,000 people who are HIV-positive and don't know it, 20,000 will test negative. The positive predictive value drops from 94.7% to about 78%, while the negative predictive value rises from 99.97% to about 99.99%.
People should be careful how they pay for the test (Score:1)
I would caution people to pay Cash only for these tests.
I remember a while back on /. there was an article on how Credit Card companies would offer people better rates if they bought some obscure combination of items at least yearly (showing they cared for their household, etc .... bird seed I seem to recall was one of the items).
Food for thought anyways.
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Huh, good point. I didn't think that credit card companies would adjust your credit score based on what you buy but I guess there's not reason they can't and they have an incentive to do so.
It's stupidly easy to get tested (for free) (Score:2)
But many people can't bear to ask someone to perform the test on them.
If you want to find out your HIV status, there's really no substitute for having it performed by someone trained to do it, and trained to privately answer every random question you have with zero judgement. For those of you who haven't done it, it's literally the most banal, undramatic process ever. HIV testing is absolutely routine and doesn't make anyone think less of you.
I mean, in some places, you can even get it done for free while s [outofthecloset.org]
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Can one have a test done anonymously by a professional?
Yes. It's incredibly easy to do, and you're unlikely to get charged for it.
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Not everyone lives in the type of city/state that you live in.
There are resources for anonymous HIV testing within reach of just about any community in the nation. Reply back if you're trying to find it in a particular city, and I'll do some digging.
Who needs specificity, with such poor sensitivity? (Score:2)
Let's not forget that the target demographic for such a test is people who are not very keen (for any sort of reason) on taking the test in the first place, otherwise they would just get tested for free at one of the many locations that do it.
Giving these people a false positive (with attached warning regarding reliability of the t
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Granted, you have a point in that people who test negative are unlikely to seek further confirmation that they are in fact HIV-negative, whereas designing a test with a high sensitivity but low specificity would result in many more follow-ups with more specific tests.
But where I think your argument treads on somewhat shaky ground is that (1) HIV is not the only STD out there, and there are lots of other very things you could catch through unprotected sex, such as hepatitis (which may lead to liver cancer);
It's only 92% accurate ... (Score:5, Insightful)
... lest you guys start thinking that this kit is a heavenly sent, that you guys will be 100% protected ...
This test kit is only 92% accurate
While 8% does not seem to be a big number, it still matters in this case for AIDS is still incurable
Re:It's only 92% accurate ... (Score:5, Informative)
No test is 100% accurate. Even ones done in a lab setting. In particular, these HIV tests require the body to produce antibodies to the virus. No antibodies, no positive test. You don't make antibodies instantly - it takes on the order of 10 - 14 days. So, if you were in contact with an HIV positive person and then ran out and got tested you would test negative. A couple of weeks later, the story might be different.
Wrap the rascal.
Re:It's only 92% accurate ... (Score:5, Interesting)
Re:It's only 92% accurate ... (Score:4, Insightful)
Yes, in this case, I'd prefer a 1 in 12 false *positive* rate. That way, if it is false, all I did was waste some time and money at a clinic to make sure. With this, if I come up negative, it might just be a false sense of security which is much worse for everyone involved.
Re:It's only 92% accurate ... (Score:5, Informative)
The test kit comes with a booklet that the manufacturer and the FDA spent quite a bit of time going back and forth about. It attempts to clearly delineate what the test can and cannot do and impresses the need to get repeat testing. Remember, this took years to get cleared and not because of the technology itself - that's pretty cut and dried.
The hard part was setting the false positive and negative rates and trying to educate the general public on how to approach this issue. Whether or not their decisions were correct remains to be seen.
The big issue, IMHO, is the fact that you're only testing for one disease. If you went into a doctor's office or an STD clinic, you would typically get tested for the other communicable diseases that tend to ride along with HIV (gonorrhea, chlamydia and to a lesser extent, syphilis and Herpes). While these won't kill you right off the bat, they are important enough in their own right.
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Precisely. The false negative rate is sufficiently large to make it pointless. Would anyone here have unprotected with someone on the basis of this test's result?
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In addition to that, during the window period of 1-3 months it might not be detected at all. Not detecting HIV does not mean the person is not infected at all.
Re:It's only 92% accurate ... (Score:5, Informative)
... lest you guys start thinking that this kit is a heavenly sent, that you guys will be 100% protected ...
This test kit is only 92% accurate
While 8% does not seem to be a big number, it still matters in this case for AIDS is still incurable
The test's accuracy is much higher than 92%. The test has 92% recall (it will correctly detect 92% of the true positives). In determining the accuracy, you need to take into account all the people who don't have HIV (which it will correctly detect 99.98% of the time). Based on the CDC's numbers, about 1 in 250 people in the U.S. have HIV, so the accuracy of this test would be (249/250)*99.98% + (1/250)*92% = 99.95%. The precision here (the probability that a positive returned by the test is a true positive) is the probability of a true positive detection over the total probability of a positive test result, or (1/250)*92% / ((1/250)*92% + (249/250)*0.02%) = 95%. In other words, if the test says you have HIV, there's a 95% chance it's correct. Doing the same for a negative result, you'll find that a negative result is correct 99.6% of the time.
Your point that the test fails to correctly detect 8% of the true positives is a reasonable one, but accuracy is not the metric you should be using to evaluate. To better illustrate why accuracy is a terrible metric to use, consider a test that always returns "no". Since 99.6% of people do not have HIV, the test is 99.6% accurate, yet totally useless (0% recall and undefined precision due to no positive results). Precision and recall are what you should care about.
TL;DR:
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That's almost correct. If you have an average risk of contracting HIV and you've never tested yourself before, then the numbers would be 95% (well, okay, that's not quite true for reasons below). If you're in a low-risk group (e.g. you don't get laid or are in a long-term monogamous relationship), then you are less likely to have HIV and there's less than a 95% chance it's correct if it says you have HIV. Conversely, if you
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I'm confused, correct me if I'm wrong but it's 92% accurate for positive, and 99% accurate for negative. That's it, if you get positive hit, you can still be in 8% with false alarm.
Or I misread BBC article about it. If so, nevermind.
Re:It's only 92% accurate ... (Score:5, Insightful)
Has AIDS become something of a crossover hit, especially but not exclusively in the developing world, with substantial uptake among behaviorally prosaic demographics? Oh yes, yes it has...
At the risk of sounding blunt to the point of crassness, if the 'AIDS = Ass Cancer' theory of epidemiology were actually accurate, we wouldn't still be talking about it. It's hard for a virus that has no significant animal vectors and can't survive outside the body worth a damn to hang on if it can only burn its way through crazy-high-risk demographics. There just aren't that many of those, and they tend to die.
Re:It's only 92% accurate ... (Score:4, Insightful)
Re:It's only 92% accurate ... (Score:5, Insightful)
It's not politically correct to mention that.
Re:It's only 92% accurate ... (Score:4, Informative)
A big part of that was the lack of condom use among homosexuals in the 70s and 80s. Who is going to wear a condom when there is no risk of anyone getting pregnant. Another risk was the fact that the homosexual community was so small and hidden back then. If one guy caught AIDS it wouldn't take long for it to make the rounds in that area due to lack of choice in partners.
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CDC figures still indicate that half of all new HIV infections are in men having sex with men (gay or bi). From what I can tell, the factors that you mention are actually still in effect and did not end in the 70s and 80s. While there is more knowledge of risk factors, that appears to be offset by the complacency of younger gay or bi men to the risks, as AIDS is no longer front page news, nor necessarily a death sentence.
2009 CDC Fact Sheet
http://www.cdc.gov/nchhstp/Newsroom/docs/FastFacts-MSM-FINAL508COM [cdc.gov]
Re:It's only 92% accurate ... (Score:4, Insightful)
I do wonder if part of that has to do with the fact that gay men also are more likely to get tested for AIDS regularly than straight guys. I live in Lakewood Ohio that has a huge openly gay community that probably rivals San Fransisco on a per capita basis. In fact the nursing home I work in has twice as many gay male employees than straight. While talking to them there seems to be a trend of being very open about multiple partners or sharing partners while they were young and usually settling down in monogamist relationships around their late 30's early 40's. But even with all the promiscuous sex there is a get tested and get tested often mentality in the community.
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ANYONE can get aids from ANYONE who has aids if you have ANY TYPE of sex. End of story.
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"specifically male to male" - actually only in the male to male community. In the lesbian community it is lower than the heterosexual community.
Re:It's only 92% accurate ... (Score:4, Informative)
you can go to the CDC website and see for yourself.
Indeed, here's a summary from the CDC [cdc.gov] from the end of last year. The most relevant part to your point:
While CDC estimates that only 4 percent of men in the United States are MSM, the rate of new HIV diagnoses among
MSM in the United States is more than 44 times that of other men (range: 522 – 989 per 100,000 MSM vs. 12 per
100,000 other men).
I have that link somewhat handy since I'm a gay male. For any other gay guys, to protect yourself...
1. Be monogamous; if you can't,
2. Skip anal and go for oral, which has a much smaller HIV transmission risk to both partners (basically 0 to the guy who's getting head); it's safest not to get cum in your mouth; if you can't,
3. Always use a condom and top--bottoming has a far higher transmission risk; if you can't,
4. Never fucking bareback with a guy you're not absolutely certain is HIV negative no matter what you asshole. You make us all look bad. If you can't,
5. Test yourself often (1-3 months). When you become positive, only have sex with other positive guys. There is no more "if you can't".
It should be noted that condom usage is highly effective but also imperfect. Depending on the study, they reduce exposure risk by only around 80%. For more precise transmission statistics, the Transmission [wikipedia.org] section of the HIV/AIDS Wikipedia article has a good summary and good sources (though you usually need journal access to read them). The Prevention section is also worth reading.
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IMHO, getting tested every 1-3 months is overkill if you practise safe sex (as everyone should). And I would never have anal sex without condom, even with a person who "absolutely certain is HIV negative", because there cannot be absolute certainty and there are other STDs as well. And because condoms are not 100 percent reliable, I refuse to have sex with persons who seem to be interested in bareback sex (if they aren't already HIV postive, they will be soon), are HIV positive or persons that I suspect mig
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I agree with all of your points. I do not agree that they were all actually relevant to my post (for instance, my 1-3 months remark was in the context of someone having bareback sex with multiple partners [note the "If you can't"'s], in which case it's perhaps even generous), but oh well. Actually, I do contest one point--"absolute certainty" about being HIV negative, while not 100%, can be extraordinarily close. One would need several tests after months of 0 risky behavior. I mostly meant to cover the case
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Yup, excellent point. I haven't actually seen statistics on how many people get infected that way, but it's of course a possibility. I remember reading an "advice to cheaters" guide that brought this up--it said that, if you're going to cheat, at *least* wear protection so the poor guy you're screwing over doesn't get sick.
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When I worked in a major hospital in Plano, Texas several years ago; anyone that came through ED as a trauma patient was given a drug scan, HIV, and HepC tests unbeknownst to the patient. It was done to protect the staff from these diseases. The drug scan was to give us a measure what the patient had on board so as to not overdose them with pain medicines and judge their tolerance for opiates.
The HIV rate was ~12% and HepC was > 50%. So, there is a definite need for this. There is a greater need for a H
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Re:Seriously? (Score:5, Funny)
oh yea thats even better, rather than the local pharmacy know, now google, facebook and every single one of their ad whores know. a few hours later their friends start noticing "HIVStick" ad's on every page
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That is absolutely ridiculous...they want to do the test themselves? Its like a huge neon sign going "HI I MAY BE HIV POSITIVE!!!". EVERYONE is going to want to do that now and they will know what it means, just like a pregnancy test, so the whole "do it at home to not feel ashamed" thought process goes right out the window. Not to mention that without the proper treatment, the people who are infected will have a bad life expectancy, won't live normal lives...just so many issues with this.
I think that's the problem this test is supposed to solve - one out of 5 people with HIV don't realize it, so the sooner they take the test, the sooner they can begin treatment since the longer they wait the harder it is to treat.
I don't know why you think that picking up a home test "for a friend" from the pharmacy or ordering it through mail order is more of a stigma than making an appointment at a clinic or with your doctor for the test.
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And right now there's an even bigger advantage: After testing positive, you can then proceed to buy health insurance. ;)
And as for 'stigma'...yeah, that's dumb. It's not a prescription, it doesn't even require ID. Just drive a few towns over and buy it with cash. Or, of course, buy it online.
If I were this company, I'd have mail-order forms in the box, with a way for people to set up a 'subscription' where they got sent a new test every three months.
Incidentally, I think instead of trying to figure out w
Re:The solution to the AIDS problem is simple: (Score:5, Informative)
I know he's trolling, but there's actually a ring of truth to it. Approximately half of all black homosexuals have HIV.
One study of five major cities found that nearly 50 percent of all Black gay and bisexual men were HIV-positive
Pretty staggering number.
source: (it's a PDF)
http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf [whitehouse.gov]
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I met a woman recently who claimed to have HIV. Her virus load was "undetectable", and I think the hepatitis C and depo-provera-induced osteoporosis (that's the 3-month birth control injection) was much more significant in her daily life than HIV ever will be.
Majic Johnson is still alive, afaik... So what else is going on with people who test positive for HIV? What is the difference between someone who dies, and someone whose body successfully keeps the virus in check?
HIV never blew up like it was supposed
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HIV is still as deadly as it ever was. The only thing that changed in the 90's is big pharma produced some drugs that inhibit the HIV virus from reproducing. Trouble is, no one drug works indefinitely. The virus adapts to the drug the patient is currently taking, and once it does, they have to switch to a new one. The side effects of these drugs are terrible, and they aren't completely effective; you still have a significantly diminished immune system.
When the virus mutates to resist drugs, it does lose som